ResearCHECK: Does Daily Aspirin Use Lower Risk of Death If You Have Ca

Several research studies have indicated that inflammation plays a role in the development of cancer and can even worsen a patient’s outcome. Aspirin and non-aspirin NSAIDs reduce inflammation. So, scientists are now looking into whether these over-the-counter drugs can lower the risk of developing certain types of cancers – or even reduce the risk of death should you have a certain cancer diagnosis.

A new study, published this week in JAMA Network Open, looked at the association of aspirin use and cancer deaths in older adults. It found that regular aspirin use, even as little as once per week, may reduce risk of death. But does that mean you should start an aspirin regimen?

We put the study through our ResearCHECK to help you better understand the science behind the study and outline what you should consider before speaking to your physician.

WHO: The study was led by five researchers from several cancer research institutions, including the National Cancer Institute, Siteman Cancer Center, Massachusetts General Hospital and Harvard Medical School.

Their funding was provided through grants from the National Cancer Institute and a research scholarship provided by Massachusetts General Hospital.

One author did disclose that he receives funding from Bayer Pharma AG and Pfizer Janssen Pharmaceuticals.

WHAT: This was a cohort study, involving a group (or cohort) of people. And it’s a large cohort of people over age 65 years old: 146,152 individuals from the Prostate, Lung, Colorectal and Ovarian Screening Trial. Researchers followed these participants for up to two decades after they enrolled in the study. Slightly more than half of the participants were female (51%); most were non-Hispanic whites (88%). Anyone with a pre-existing history of colorectal, lung, prostate or ovarian cancer was excluded from the group. The objective of this cohort study was to investigate the association of aspirin use with risk of death from all-causes (any type of disease), any cancer, gastrointestinal (GI) cancer, and colorectal cancer (CRC) among older adults.

HOW: The researchers analyzed aspirin use among participants by collecting information when the participant joined the study (at baseline) between Nov. 1993 and July 2001, and again during a follow-up period (2006-2008) among those who had reached age 65 or older. Analysis of the data began in late 2018 and concluded in September 2019. The data suggests that aspirin use three or more times per week was associated with a reduction in all-cause, any cancer, GI cancer and CRC death rates in older adults. Seniors with prostate, lung, colorectal or ovarian cancer who used aspirin three or more times per week were 19% less likely to die during the follow-up period than those who didn't use it at all. Those with CRC or GI cancers benefitted the most, with a 25-29% reduction in risk of death.

CONTEXT: These findings are consistent with previous research showing aspirin use over 10 years or more can reduce the chance of developing or dying from cancer, especially gastrointestinal cancers. Notably, results from the NIH-AARP study, the Nurses’ Health Study, and Health Professionals Follow-up Study demonstrated that long-term regular aspirin use was associated with reduced risk of obesity- and inflammation-associated cancers, particularly colorectal cancer. When it comes to aspirin’s effects on other types of cancer, an extensive review of literature by the U.S. Preventive Services Task Force in 2015 found that daily use of low-dose or regular aspirin for four or more years was linked to a significant reduction in deaths from cancer and all disease causes. But not much has been published about such daily aspirin regimens in people over age 65, as were the participants in this study.

BOTTOM LINE: If you’re over 65, this might be worth discussing with your physician. You’ll want to weigh potential benefits against bleeding risks associated with aspirin/NSAID use. However, it’s important to remember that this is an association study only. It does not necessarily mean taking aspirin will reduce a person’s risk of developing cancer or help avoid worse outcomes. It shows there is a link that requires further investigation and clinical study.

Dr. Shelley Tworoger, associate center director of Population Science at Moffitt Cancer Center

Dr. Shelley Tworoger, associate center director of Population Science at Moffitt Cancer Center, adds, “In addition to potentially reducing cancer-related mortality, aspirin use can also lower one’s chance of getting heart disease. However, some people can have stomach problems from taking aspirin, so it is important to speak to you doctor before taking aspirin on a regular basis.”

ResearCHECK is an effort of Moffitt Cancer Center to provide context and better understanding of research studies featured in the news. It presents key elements of research publications in language that’s more accessible to non-scientists:

who did the study and who funded it
what questions were the researchers trying to answer
what type of participants were included in the study and how many
how did the researchers obtain their findings
putting those findings in context of prior research and needs for further study
a “bottom line” summary of the study’s possible relevance to our readers

ResearCHECK is not intended to provide guidance for clinical questions, but rather to serve as a starting point for discussions between patients and their physicians.

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