Daily Low-Dose Aspirin, Round 2

(For Round 1, see this comment from last year.)

NYT: Studies Link Daily Doses of Aspirin to Reduced Risk of Cancer

One of the new studies examined patient data from dozens of large, long-term randomized controlled trials involving tens of thousands of men and women. Researchers at the University of Oxford found that after three years of daily aspirin use, the risk of developing cancer was reduced by almost 25 percent when compared with a control group not taking aspirin. After five years, the risk of dying of cancer was reduced by 37 percent among those taking aspirin.

A second paper that analyzed five large randomized controlled studies in Britain found that over six and a half years on average, daily aspirin use reduced the risk of metastatic cancer by 36 percent and the risk of adenocarcinomas — common solid cancers including colon, lung and prostate cancer — by 46 percent.

The article is worth reading in its entirety, but here's an especially interesting paragraph:

The new studies, however, also found that the risk of bleeding in aspirin users diminished over time, and that the risk of death from brain bleeds was actually lower in the aspirin users than in the comparison group.

The evidence still isn't perfect, but the purpose of rationality is making good decisions with limited information. I am a healthy 28-year-old and these studies make me even more confident that taking daily low-dose aspirin is the right thing for me to do.

On a related note, if society were more rational, I wouldn't have to be sad reading paragraphs like this one:

Some cancer doctors commended the new research, saying said that despite the limitations of the analyses, no other long-term clinical trials of aspirin and cancer are likely to be done because of the enormous expense involved and the fact that aspirin is a cheap generic drug.

Or these ones from A Cheap Drug Is Found to Save Bleeding Victims, published on the same day:

For months, a simple generic drug has been saving lives on America’s battlefields by slowing the bleeding of even gravely wounded soldiers.

Even better, it is cheap. But its very inexpensiveness has slowed its entry into American emergency rooms, where it might save the lives of bleeding victims of car crashes, shootings and stabbings — up to 4,000 Americans a year, according to a recent study.

Because there is so little profit in it, the companies that make it do not champion it.

(For Round 1, see this comment from last year.)

NYT: Studies Link Daily Doses of Aspirin to Reduced Risk of Cancer

One of the new studies examined patient data from dozens of large, long-term randomized controlled trials involving tens of thousands of men and women. Researchers at the University of Oxford found that after three years of daily aspirin use, the risk of developing cancer was reduced by almost 25 percent when compared with a control group not taking aspirin. After five years, the risk of dying of cancer was reduced by 37 percent among those taking aspirin.

A second paper that analyzed five large randomized controlled studies in Britain found that over six and a half years on average, daily aspirin use reduced the risk of metastatic cancer by 36 percent and the risk of adenocarcinomas — common solid cancers including colon, lung and prostate cancer — by 46 percent.

The article is worth reading in its entirety, but here's an especially interesting paragraph:

The new studies, however, also found that the risk of bleeding in aspirin users diminished over time, and that the risk of death from brain bleeds was actually lower in the aspirin users than in the comparison group.

On a related note, if society were more rational, I wouldn't have to be sad reading paragraphs like this one:

Some cancer doctors commended the new research, saying said that despite the limitations of the analyses, no other long-term clinical trials of aspirin and cancer are likely to be done because of the enormous expense involved and the fact that aspirin is a cheap generic drug.

Or these ones from A Cheap Drug Is Found to Save Bleeding Victims, published on the same day:

For months, a simple generic drug has been saving lives on America’s battlefields by slowing the bleeding of even gravely wounded soldiers.

Even better, it is cheap. But its very inexpensiveness has slowed its entry into American emergency rooms, where it might save the lives of bleeding victims of car crashes, shootings and stabbings — up to 4,000 Americans a year, according to a recent study.

Because there is so little profit in it, the companies that make it do not champion it.

First study fulltext: Rothwell et al 2012, "Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials" http://www.istudymedicine.com/wp-content/uploads/aspirin.pdf
Second: Rothwell et al 2011, "Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials" http://www.beppegrillo.it/immagini/Aspirin%20and%20death%20from%20cancer%20$Lancet%202010$.pdf

Now that these are available, I've read through them and specifically looked at any mentions of all-cause mortality; while most of the all-cause figures are not statistically-significant, in every case the point-value seems to be consistently lower (ie. the baby aspirin was helpful). I didn't find any all-cause numbers cited in which the aspirin group died more.

I was critical in the earlier discussion because we weren't seeing the all-cause numbers and there are excellent reasons to be wary of medical results, but personally I find all-cause mortality to be a very persuasive metric, and in the absence of any contraindications for myself or finding that the all-cause numbers have been fudged, I think I'll start low-dose/baby aspirin. My main worry is that most of these studies only deal with older people and the benefits might be negative in younger people, but it also looks like the effect is cumulative so one might want to start early. (The medical aspects are my only concern - money-wise, it might as well be free; for example, here on Amazon is 730 tablets or 2 years' worth for $8.)

A large recent trial appears to show that low-dose aspirin isn't helpful, and may be harmful, for healthy older people.

4jsalvatier12y

Are you now taking low-dose aspirin?

-1Kawoomba13y

Thanks dawg, low-dose aspirin and Vitamin D it is for me as well. Your comment had an impact. [...] No aspirin for kids, Holmes.