(ChemotherapyAdvisor) – New data from the American Cancer Society (ACS) suggest recent daily aspirin use is associated with modestly lower cancer mortality; however, this reduction may be not be as great as that suggested by a recent pooled analysis of randomized trials of daily aspirin, investigators concluded in the Journal of the National Cancer Institute online August 10.

Study participants were 100,139 men and women with no history of cancer enrolled in the Cancer Prevention Study II Nutrition Cohort, of whom 5,138 died from cancer between 1997 and 2008.

Daily aspirin use at baseline—compared with no use—was associated lower cancer mortality, regardless of duration of daily use (<5 years, RR 0.92, 95% CI, 0.85–1.01; for ≥5 years, RR 0.92, 95% CI, 0.83–1.02), Eric J. Jacobs, PhD, and ACS colleagues reported.

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“Associations were slightly stronger in analyses that used updated aspirin information from periodic follow-up questionnaires and included 3,373 cancer deaths (for <5 years of use, RR 0.84, 95% CI, 0.76-0.94; for ≥5 years of use, RR 0.84, 95% CI, 0.75-0.95),” they wrote.

An accompanying editorial noted, “Overall, the well-conducted ACS study is an echo of other data on aspirin and cancer mortality, not a resounding confirmation…The drug clearly reduces the incidence and mortality from luminal gastrointestinal cancers, and it may similarly affect other cancers. This is exciting: simply taking a pill can prevent cancer incidence and cancer death. However, just because aspirin is effective does not mean it necessarily should be used. Aspirin is a real drug, with definite toxicity. As for any preventative intervention, the benefits must be balanced against the risks, particularly when the benefits are delayed whereas the risks are not. The ACS data have the potential to help us assess the risk–benefit balance by providing a unique window on aspirin’s effects.”


Editorial (full text)