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Aspirin: UK study finds major reduction in cancer death

Oxford U. study shows aspirin improves cancer survival by lowers the risk of metastasis 40-50%.   This figure is low, because it includes both short-term usage, and low dose (under 150 mgs.) aspirin. This study is consistent with the Nurse’s Health Study which found for breast cancer stage I, II, III had a 70% greater survival if they took 2 or more aspirins per week. It was a long-term study, and far fewer were taking the low-dose aspirin.  For Nurses’ Study, Journal of Clinical Oncology, Accepted 12/9/09. All this has been known for decades (1986 Harvard Nurses study, and 1991 University of Toronto meta study on colon cancer, to name two on aspirin).

Studies say aspirin may help treat or prevent cancer

Updated: 18:53, Wednesday, 21 March 2012 -- a large Ireland media network.

{Article at, The Lancet, Volume 379, Issue 9826, Pages 1591-1601, 28 April 2012 doi:10.1016/S0140-6736(12)60209-8}

Three new studies found that taking aspirin may prevent cancer and reduce the likelihood that cancers will spread to other organs.

Three new studies have added to growing scientific evidence suggesting that taking a daily dose of aspirin can help prevent, and possibly treat, cancer.  However, there remain some concerns about the drugs side-effects.  Previous studies have found that daily aspirin reduces the long-term risk of death due to cancer, but until now the shorter-term effects have been less certain, as has the medicine's potential in patients already diagnosed with cancer.  The new studies, led by Peter Rothwell of Britain's Oxford University, found that aspirin also has a short-term benefit in preventing cancer, and that it reduces the likelihood that cancers will spread to other organs by about 40 to 50%.  {There is still the delay in prevention of about 10 years, but not in improving cancer survival.—jk}

"These findings add to the case for use of aspirin to prevent cancer, particularly if people are at increased risk," Mr Rothwell said.  "Perhaps more importantly, they also raise the distinct possibility that aspirin will be effective as an additional treatment for cancer, to prevent distant spread of the disease."  This was particularly important, he said, because it is the process of the spread of cancer, or "metastasis", which most often kills people with the disease.

Aspirin is a cheap over-the-counter drug generally used to combat pain or reduce fever.  It reduces the risk of clots forming in blood vessels and can therefore protect against heart attacks and strokes.  It is often prescribed for people who already suffer with heart disease and have already had one or several attacks.  However, Aspirin also increases the risk of bleeding in the stomach to around one patient in every thousand per year. 

This has fuelled an intense debate about whether doctors should advise patients to take it as regularly as every day.  Last year, a study by British researchers questioned the wisdom of daily aspirin for reducing the risk of early death from a heart attack or stroke because they said the increased risk of internal bleeding outweighed the potential benefit.  Other studies, including some by Mr Rothwell in 2007, 2010 and 2011, found that an aspirin a day, even at a low dose of around 75 milligrams, reduces the long-term risk of developing some cancers, particularly bowel and oesophageal cancer, but the effects don't show until eight to 10 years after the start of treatment.

Mr Rothwell, whose new studies were published in The Lancet and The Lancet Oncology journals, said this delay was because aspirin was preventing the very early development of cancers and there was a long time lag between this stage and a patient having clinical signs or symptoms of cancer.  Mr Rothwell and others said deeper research was now needed into aspirin as a potential treatment for cancer in patients whose disease has not yet spread.  "No drug has been shown before to prevent distant metastasis and so these findings should focus future research on this crucial aspect of treatment," he said.

Peter Johnson, chief clinician at the charity Cancer Research UK, said his group was already investigating the anti-cancer properties of aspirin. "These findings show we're on the right track," he said.

In a written commentary on the research in The Lancet, Andrew Chan and Nancy Cook of Harvard Medical School in the United States said it was "impressive" and moved health experts "another step closer to broadening recommendations for aspirin use".


Even more positive results would have been the results if they had excluded the low dose aspirin, and just considered the 325 mg dose.

The Lancet, Volume 379, Issue 9826, Pages 1591 - 1601, 28 April 2012 doi:10.1016/S0140-6736(12)60209-8

Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials

Prof Peter M Rothwell FMedSci



Daily aspirin reduces the long-term incidence of some adenocarcinomas, but effects on mortality due to some cancers appear after only a few years, suggesting that it might also reduce growth or metastasis. We established the frequency of distant metastasis in patients who developed cancer during trials of daily aspirin versus control.


Our analysis included all five large randomised trials of daily aspirin (≥75 mg daily) versus control for the prevention of vascular events in the UK. Electronic and paper records were reviewed for all patients with incident cancer. The effect of aspirin on risk of metastases at presentation or on subsequent follow-up (including post-trial follow-up of in-trial cancers) was stratified by tumour histology (adenocarcinoma vs other) and clinical characteristics.


Of 17 285 trial participants, 987 had a new solid cancer diagnosed during mean in-trial follow-up of 65 years (SD 20). Allocation to aspirin reduced risk of cancer with distant metastasis (all cancers, hazard ratio [HR] 064, 95% CI 048—084, p=0001; adenocarcinoma, HR 054, 95% CI 038—077, p=00007; other solid cancers, HR 082, 95% CI 053—128, p=039), due mainly to a reduction in proportion of adenocarcinomas that had metastatic versus local disease (odds ratio 052, 95% CI 035—075, p=00006). Aspirin reduced risk of adenocarcinoma[1] with metastasis at initial diagnosis (HR 069, 95% CI 050—095, p=002) and risk of metastasis on subsequent follow-up in patients without metastasis initially (HR 045, 95% CI 028—072, p=00009), particularly in patients with colorectal cancer (HR 026, 95% CI 011—057, p=00008) and in patients who remained on trial treatment up to or after diagnosis (HR 031, 95% CI 015—062, p=00009). Allocation to aspirin reduced death due to cancer in patients who developed adenocarcinoma, particularly in those without metastasis at diagnosis (HR 050, 95% CI 034—074, p=00006). Consequently, aspirin reduced the overall risk of fatal adenocarcinoma in the trial populations (HR 065, 95% CI 053—082, p=00002), but not the risk of other fatal cancers (HR 106, 95% CI 084—132, p=064; difference, p=0003). Effects were independent of age and sex, but absolute benefit was greatest in smokers. A low-dose, slow-release formulation of aspirin designed to inhibit platelets but to have little systemic bioavailability was as effective as higher doses.


That aspirin prevents distant metastasis could account for the early reduction in cancer deaths in trials of daily aspirin versus control. This finding suggests that aspirin might help in treatment of some cancers and provides proof of principle for pharmacological intervention specifically to prevent distant metastasis.






[1] Adenocarcinoma  is a cancer that originates in glandular tissue. This tissue is also part of a larger tissue category known as epithelial tissue. Epithelial tissue includes skin, glands and a variety of other tissue that lines the cavities and organs of the body. Epithelium is derived embryologically from ectoderm, endoderm and mesoderm. To be classified as adenocarcinoma, the cells do not necessarily need to be part of a gland, as long as they have secretory properties.  Adenocarcinomas can arise in many tissues of the body due to the ubiquitous nature of glands within the body. While each gland may not be secreting the same substance, as long as there is an exocrine function to the cell, it is considered glandular and its malignant form is therefore named adenocarcinoma.  Tissues include, lung, prostate, urachus, vagina, breast, esophagus, pancreas, stomach, throat, some cervical, most colon, and like cancers.

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Disclaimer:  The information, facts, and opinions provided here is not a substitute for professional advice.  It only indicates what JK believes, does, or would do.  Always consult your primary care physician for any medical advice, diagnosis, and treatment.