Regular use of aspirin can keep the oncologist at bay, at least in terms of colorectal cancer, according to a new study, and people with an unhealthy lifestyle seem to have the greatest benefits.
Colorectal cancer is the second leading cause of cancer death worldwide, according to the World Health Organization (WHO), and is estimated to cause more than 52,500 deaths in the United States alone in 2023.
About 153,020 Americans will be diagnosed in 2023, with colorectal cancer becoming much more common among people under 55, more than double in this group compared to a decade ago, studies show.
The causes of colorectal cancer can be genetic, but certain lifestyle factors also appear to increase the risk, including an unhealthy diet, lack of exercise, alcohol consumption, smoking and a high body mass index (BMI).
In addition to adopting a healthier lifestyle, doctors often recommend low-dose aspirin to reduce the risk of colon cancer.
The US Preventive Services Task Force made recommendations on aspirin in 2016 but reversed the decision in 2022 due to concerns that it could cause bleeding. Aspirin can also cause gastrointestinal problems.
With the change in recommendations, the authors of the new study decided to analyze whether there are groups that would benefit more from this practice and for whom aspirin would be worth the risk.
For this study, published Thursday in the journal JAMA Oncology, the authors examined data from more than 107,655 people who were part of large healthcare workforce datasets called the Nurses’ Health and Follow-up Study and the Nurses’ Health Professionals Study ‘ Health Study and Health Professionals Follow-Up Study). Most of the participants were white, so the authors suggest that the research should be replicated in more diverse populations to validate this conclusion.
Study participants were followed for at least a decade and, in addition to being monitored for colorectal cancer, answered questionnaires to determine whether their lifestyle was healthy.
The questionnaires assessed BMI, alcohol consumption, and diet, whether they smoked, and how much they exercised.
The use of two or more regular-strength aspirins, or six or more low-dose aspirins, per week was considered regular aspirin use for the purposes of this research.
It was found that regular users have an 18% lower risk of developing colorectal cancer than non-users.
Participants who were classified as having a less healthy lifestyle had more benefits, particularly if they smoked or had a BMI greater than 25. A BMI of 25 to 29.9 is considered overweight.
“Our results show that aspirin can proportionally reduce the significantly elevated risk in those with multiple risk factors for colorectal cancer,” said Dr. Daniel Sikavi, lead author of the paper and a gastroenterologist at Harvard University Hospital, Mass General Brigham (MGB), in – a statement.
In contrast, those with a healthier lifestyle had a lower baseline risk of colorectal cancer, and therefore their benefit from aspirin was still evident, although less pronounced, he said.
The study could not determine why regular aspirin use appears to be so helpful, but previous research has suggested that aspirin may inhibit pro-inflammatory signals that can lead to cancer.
Although other studies have shown the benefits of aspirin in preventing colorectal cancer among certain populations, the results have been inconsistent, according to the authors of the new research. They argue that doctors should weigh different lifestyle risk factors when determining whether a person should take aspirin regularly to prevent colorectal cancer.
Dr. Christina Annunziata, senior vice president at the American Cancer Society, noted that the research showed the greatest effect of aspirin in people with the most risk factors for colon cancer.
It is important to keep in mind that the study, which compared people who received aspirin with those who did not, was not a randomized clinical trial (the gold standard), which means that there are limitations that must be considered and will more research is needed, she said, but it can serve as “a good reminder” that it’s not inevitable and that people can take steps to reduce their cancer risk.
“There are things you can change about your lifestyle that will reduce your risk,” Dr. Annunziata, who was not involved in the new research, told CNN.
These include maintaining a healthy weight, eating a diet rich in vegetables, fruits, and whole grains, and drinking less alcohol.
Dr. Raymond DuBois, past president of the American Association for Cancer Research, said that as he watched the evolution of aspirin recommendations for more than two decades, he always wondered why some studies showed a benefit and others did not. He believes this research could help solve this mystery.
The evidence from the study, DuBois said, demonstrates “quite convincingly” the beneficial effect of aspirin for the unhealthiest group of participants.
“We try as much as we can to get the population to a healthier state, but for some people, it’s very difficult to lose weight or quit smoking. This could be a simple option that could help, especially for those who are at the highest risk,” said Dr. DuBois, director of the Medical University of South Carolina Cancer Center, who was not involved in the new study.
Since it only took two aspirins taken regularly a week to show a benefit, it could alleviate some concerns about the risk of bleeding, he said, particularly if people took the pills during the week.
Dr. Jennifer Davids, chief of colon and rectal surgery at Boston Medical Center, says she would very much like people to avoid her office, but cautions that not everyone should start taking aspirin.
“It’s cheap, it’s affordable, but it’s not without risk,” said Dr. Davids, who was not involved in the new research.
She said the study is an important step in the right direction in trying to understand who has the potential to benefit most from aspirin, but that people should first talk to their family doctor to determine if aspirin is right for them. for them.
At the same time, the doctor added that taking aspirin “does not mean giving up a healthy diet, physical exercises, avoiding smoking and minimizing alcohol consumption”.
“By no means is an aspirin going to make up for all the other factors that are necessary for a healthy lifestyle and overall cancer risk reduction,” she said.
