Diana Zuckerman, PhD: Cancer Prevention and Treatment Fund
Many Americans take low-dose aspirin, also called baby aspirin, to prevent cancer and heart disease. However, by 2019, the latest research suggested that aspirin is not as helpful as many patients believe.
In 2016, the U.S. Preventive Service Task Force (USPSTF), an independent group of medical experts, recommended low-dose aspirin “for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk [risk of developing cardiovascular disease], are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years”.1 They did not recommend aspirin to prevent all types of cancer, only colorectal cancer.
Primary prevention means preventing a disease that a person has not yet developed. As you can see above, there were quite a few caveats on who might benefit from “baby” low dose aspirin (typically 81mg). For example, patients with an increased risk of bleeding due to certain medications, or with a history of other medical conditions such as stomach or intestinal ulcers, kidney disease, or severe liver disease.1
Recommended Guidelines in 2019 from the American College of Cardiology (ACC) and the American Heart Association were not as enthusiastic about aspirin for primary prevention of heart disease, saying that “low-dose aspirin might be considered” for certain patients.2 They did not comment on aspirin to prevent cancer.
Studies published almost a decade ago had mixed results for cancer prevention. One study suggested that a daily dose of at least 75mg aspirin taken for several years could reduce the risk of developing colorectal cancer or dying from it.3 Other studies suggested that aspirin may reduce mortality from other cancers, as well as reducing the chances of cancer spreading.4,5 However, a 2019 meta-analysis that combined results from several studies found aspirin did not significantly affect cancer mortality.6 One clinical trial known as ASPREE (Aspirin in Reducing Events in the Elderly) found that individuals who took aspirin were more likely to die from cancer.
In conclusion, more research is needed to conclusively determine whether daily baby aspirin can help to prevent cancer.
Bottomline: Do I Need Aspirin?
Some patients think they may as well take aspirin, because it might help and won’t harm. That’s not an accurate assumption. Aspirin can have risks even at low doses. You should discuss aspirin therapy with your doctor and let him or her know:
- Your medical history and the medicines you are currently using, whether they are prescription or over-the-counter
- Any allergies or sensitivities you may have to aspirin
- Any vitamins or dietary supplements you are currently taking
Other Ways to Prevent Heart Disease and Cancer
To reduce your risk of colorectal cancer, don’t smoke, don’t drink alcohol in excess, have a healthy diet, stay physically active, and maintain a healthy weight. Being older, and having a family history of colon cancer, Crohn’s disease, or ulcerative colitis are the risk factors you can’t control.7
To reduce your risk of heart disease, don’t smoke, keep your cholesterol and blood pressure under control, and do what you need to do to prevent diabetes. Being a man and older are risk factors you can’t control.8
All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.
References:
- Final recommendation statement: Aspirin use to prevent cardiovascular disease and colorectal cancer: Preventive Mmedication. U.S. Preventive Services Task Force. 2017.
https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer - , , Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Journal of the American College of Cardiology. 2019;17:CIR0000000000000678. http://www.onlinejacc.org/content/early/2019/03/07/j.jacc.2019.03.010?_ga=2.223365151.502443893.1555427130-1631669420.1554414836
- Rothwell PM, Wilson M, Elwin CE, et al. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet. 2010;376(9754): 1741-50. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61543-7/fulltext
- Rothwell PM, Folkes FG, Belch JF, et al. Effect of daily aspirin on long-term risk of death due to cancer: Analysis of individual patient data from randomised trials. Lancet. 2011;377(9759): 31-41. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62110-1/fulltext
- Rothwell PM, Wilson M, Price JF, et al. Effect of daily aspirin on risk of cancer metastasis: A study of incident cancers during randomised controlled trials. Lancet. 2012;379(9826): 1591-1601. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60209-8/fulltext
- Zheng SL, Roddick AJ. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: A systematic review and meta-analysis. JAMA. 2019;321(3):277-287. https://www.ncbi.nlm.nih.gov/pubmed/30667501
- Colorectal Cancer Risk Factors. American Cancer Society. https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html
- How to Prevent Heart Disease. Medline Plus. Last reviewed 2015. https://medlineplus.gov/howtopreventheartdisease.html