ASPİRİN HANGİ KANSERLERİ ÖNLEYEBİLİR?
Queen Mary Üniversitesi’nde görevli bilimadamları tarafından yapılan ve sonuçları “Annals of Oncology” dergisinde yayımlanan araştırma çerçevesinde, aspirin kullanımının faydaları ve zararlarının araştırıldığı yaklaşık 200 çalışmanın incelendiği belirtildi.
Hergün alınan aspirinin, sigarayı bırakmak ve obeziteyi azaltmaktan sonra kanserle mücadelede en önemli etken olabileceğini belirten bilimadamları, İngiltere’de 50 yaş üzerinde herkesin, 10 yıl süresince hergün aspirin alması durumunda, gelecek 20 yılda 122 bin ölümün önlenebileceğini öngördü.
Bilimadamları, iç kanamaya yol açabilen aspirinin, mutlaka doktora danışılarak kullanılması uyarısında da bulundu.
Araştırmada, hergün aspirin kullanımının, kolon, mide ve özefagus kanserlerden ölüm vakalarını, yaklaşık yüzde 30 ila 40 oranında azalttığı gözlendi.
Bilimadamları, ilacın, meme, prostat ve akciğer kanserlerinden ölüm oranını azalttığı konusunda ise daha zayıf ve değişken bulguların elde edildiğini açıkladı.
Araştırma, kişilerin aspirinden fayda sağlamak için en az 5 yıl boyunca ilacı kullanması gerektiğini ortaya koyarken, araştırma ekibinin lideri Profesör Jack Cuzick, 50 yaş ve üzerinde sağlıklı herkesin, 10 yıl boyunca her gün düşük dozda (75 mg) aspirin alması tavsiyesinde bulundu.
Kaynak:
cancernetwork
Daily Aspirin Use May Prevent Cancer
News | August 07, 2014 | Colorectal Cancer, Gastrointestinal Cancer
By Anna Azvolinsky, PhD
Daily low-dose aspirin could prevent cancer and reduce deaths from cancer.
Many people already take an aspirin once a day to reduce the risk of a cardiovascular event such as a heart attack or stroke. Accumulating evidence has also suggested that aspirin could cut the risk of a cancer diagnosis or the chance of dying from commonly diagnosed cancers. However, studies and clinical trials have been mixed. Some studies have shown a marked preventive benefit of a daily aspirin (see Aspirin May Lower Risk of Pancreatic Cancer and For Some, Aspirin Cuts Colon Cancer Risk in Half). But others suggested that the potential cancer prevention benefits of aspirin don’t outweigh the risks of gastrointestinal bleeding and peptic ulcers, particularly in those who are older.
Now, the most comprehensive and up-to-date pooled analysis of research studies and clinical trials suggests that the cancer prevention benefits of a daily low-dose aspirin for at least 5 years outweigh the potential harms. The review, published in Annals of Oncology, is the largest meta-analysis yet on the over-the-counter pill’s ability to stave off disease.
The pooled analysis, led by Jack Cuzick, PhD, of the Wolfson Institute of Preventive Medicine, Queen Mary University of London in the United Kingdom, shows that individuals between the ages of 50 and 65 should consider a daily prophylactic aspirin.
The researchers’ analysis suggests that a low-dose aspirin taken every day for a decade can reduce colorectal cancers by about 35% and deaths from these cancers by 40%. Rates of stomach and esophageal cancers could be decreased by 30% and deaths from these cancers by about 35% and 50%, respectively.
“There is clear evidence for a benefit in the general population aged 50 to 65 based mostly on a reduction in cancer incidence and mortality,” Cuzick told Cancer Network. “The biggest effect is in bowel, stomach, and esophageal cancers with 30% or more reductions, and small benefits for lung, breast, and prostate cancers of about 10%. [We did not find] effects on other cancers.”
Three years of use appears to be the minimum to see any benefits; at least 5 years of use is needed to see reductions in death from cancer and 10 years are likely needed for full benefits. Long-term benefits were seen in long-time users, even after stopping the daily regimen.
The analysis showed that for those individuals of average risk who are between the ages of 50 and 65, a daily aspirin for 10 years can result in a relative decrease between 7% (for women) and 9% (for men) in the number of heart attacks, strokes, and cancer cases over a 15-year period. The overall relative reduction in death from 10 years of daily aspirin use is about 4% over a 20-year period.
Although there were no differences seen for low vs standard doses, including no excess toxicities with higher doses, none of the studies had direct comparisons.
“Increased bleeding is the most important side effect of aspirin,” said the study authors, and the most serious, potentially fatal, but rare side effect is hemorrhagic stroke. Taking aspirin every day for 10 years increases the risk of stomach bleeding from 2.2% to 3.6% among 60-year-olds. In about 5% of the cases, stomach bleeding may be fatal.
“Some people are at increased risk of bleeding, [such as those individuals ] taking blood thinning drugs like warfarin, diabetics, and those with hypertension, where aspirin is not appropriate,” said Cuzick.
Bleeding may be more common in those who have the bacterium Helicobacter pylori (H. pylori ) in their stomachs, which is a cause of peptic ulcers. H. pylori may account for about one-quarter to one-third of peptic ulcers. In those who use non-steroidal anti-inflammatory drugs, an H. pylori infection has been linked with a 2- to 3.5-fold higher risk of a peptic ulcer and a 2- to 2.5-fold higher risk of gastrointestinal bleeding. There are tests available that show whether this bacterium is present in the gut; they are recommended before considering a daily prophylactic aspirin regimen.
Still, the authors stated that more research is needed to understand the benefits of aspirin, as well as which subpopulations will derive the maximum benefit and which individuals have a higher risk of bleeding. Another outstanding question is whether a baby aspirin—less than 100 mg per day—or a standard dose of 300 mg is better. Cuzick and his coauthors also pointed out that it is unclear if there is an upper age limit at which the harms of a daily aspirin do outweigh the benefits, since bleeding risk changes with age and rates of cancer increase.
– See more at: http://www.cancernetwork.com/news/daily-aspirin-use-may-prevent-cancer?GUID=5A514440-9926-4526-A4A9-DED04057940B&rememberme=1&ts=08082014#sthash.l0BTyqJo.dpuf
Daily Aspirin Use May Be Linked To Lower Risk Of Bowel, Stomach Cancers.
Reuters (8/6, Kelland) reports that research published in the Annals of Oncology suggests that daily aspirin use may be linked to a lower risk of cancers of the bowel, stomach, and esophagus. The medication was also linked to a lower risk of dying from these conditions.
AFP (8/6) reports that investigators analyzed data from more than 200 studies. The researchers “found that taking aspirin for 10 years could cut bowel cancer cases by around 35 percent and deaths by 40 percent.” The “rates of oesophageal and stomach cancers were cut by 30 percent and deaths from these cancers by 35-50 percent.”
MedPage Today (8/5, 205K) reports, “Long-term regular aspirin use was associated with a 4% reduction in the risk of premature death over 20 years.”
BBC News (8/6, Mundasad, 1.17M) reports, “There was weaker and more variable evidence that the drug reduced deaths from breast, prostate and lung cancer too.” The research found that “people needed to take the drug for at least five years to see any benefits.” The Telegraph (UK) (8/6, Smith, 3.23M) also covers the story.
(Reuters) – Taking a small daily dose of aspirin can significantly reduce the risk of developing – or dying from – bowel, stomach and oesophageal cancer, according to a large review of scientific studies.
Researchers who analyzed all available evidence from studies and clinical trials assessing benefits and harm found that taking aspirin for 10 years could cut bowel cancer cases by around 35 percent and deaths from the disease by 40 percent.
Rates of oesophageal and stomach cancer were cut by 30 percent and deaths from these cancers by 35 to 50 percent.
Professor Jack Cuzick, head of the center for cancer prevention at Queen Mary University of London, said the evidence showed that, to reap the benefits of aspirin, people need to take a daily dose of 75 to 100 milligrams for at least five years and probably up to 10 years between the ages of 50 and 65.
No benefit was seen while taking aspirin for the first three years and death rates were only reduced after five years, he and his team reported in a review in the Annals of Oncology journal.
“Our study shows that if everyone aged between 50 and 65 started taking aspirin daily for at least 10 years, there would be a 9 percent reduction in the number of cancers, strokes and heart attacks overall in men, and around 7 percent in women,” Cuzick said in a statement about the research.
But the researchers also warned that taking aspirin long-term increases the risk of bleeding in the stomach: among 60-year-olds who take daily aspirin for 10 years, the risk of digestive tract bleeding increases from 2.2 percent to 3.6 percent, and this could be life-threatening in a small proportion of people, they said.
“Whilst there are some serious side effects that can’t be ignored, taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to implement,” Cuzick said.
Aspirin, originally developed by the German drugmaker Bayer, is a cheap, over-the-counter drug generally used to combat pain or reduce fever.
The drug reduces the risk of clots forming in blood vessels and can therefore protect against heart attacks and strokes, so it is often prescribed for people who already suffer with heart disease and have already had one or several attacks.
Aspirin also increases the risk of bleeding in the stomach to around one patient in every thousand per year, a factor which has fueled debate over whether doctors should advise patients to take it as regularly as every day.
Cuzick said the risk of bleeding “depends on a number of known factors which people need to be aware of before starting regular aspirin” and advised people to consult a doctor before embarking on daily medication.
(Reporting by Kate Kelland; Editing by Larry King)
Aspirin reduces risk of some cancers, says stud.
View photo
Daily, long-term doses of aspirin can slash the risk of cancer of the digestive tract, according to new research (AFP Photo/Tim Boyle)
Paris (AFP) – Daily, long-term doses of aspirin can slash the risk of cancer of the digestive tract, according to research published on Wednesday.
Aspirin greatly reduces the risk of developing and dying from bowel, stomach and oesophageal cancer, its authors said.
They found that taking aspirin for 10 years could cut bowel cancer cases by around 35 percent and deaths by 40 percent.
Rates of oesophageal and stomach cancers were cut by 30 percent and deaths from these cancers by 35-50 percent.
To gain these benefits meant people had to start taking a daily dose of 75-100 mg for at least five years and probably 10 years between the ages of 50 and 65.
No benefit was seen while they took aspirin for the first three years, and death rates were only reduced after five years.
Aspirin has long been considered to be a boost in the fight against cardiovascular disease and has also been investigated for reputed anti-cancer effects.
This is the first to throw up broad evidence that it can be a shield against these types of cancer, the scientists said.
The study, published in the European cancer journal Annals of Oncology, was led by Jack Cuzick, a professor at the the Centre for Cancer Prevention at Queen Mary University of London.
It looked at more than 200 clinical trials and other studies that explored aspirin’s anti-cancer effects.
“Our study shows that if everyone aged between 50-65 started taking aspirin daily for at least 10 years, there would be a nine-percent reduction in the number of cancers, strokes and heart attacks overall in men and around seven percent in women,” Cuzick said in a press release.
“The total number of deaths from any cause would also be lower, by about four percent over a 20-year period. The benefits of aspirin use would be most visible in the reduction in deaths due to cancer.”
The research said there was a downside to taking daily doses of aspirin — potential side-effects such as peptic ulcers and bleeding in the digestive tract. In a very small number of elderly people, the bleeding could be life-threatening.
It said further work was needed to see who would benefit most from taking aspirin and determining the right dose to maximise the protective effect.
“It has long been known that aspirin – one of the cheapest and most common drugs on the market – can protect against certain types of cancer,” Cuzick said.
“But until our study, where we analysed all the available evidence, it was unclear whether the pros of taking aspirin outweighed the cons.”
Cuzick added: “Whilst there are some serious side effects that can’t be ignored, taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to impleme
Benefits Add Up for Regular Aspirin Use
Published: Aug 5, 2014
By Charles Bankhead, Staff Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
Discussants: Donna Arnett, PhD; Aaron D. Berman, MD; Joseph Chao, MD; Marc Itskowitz, MD; Neal Meropol, MD.
Please click the bottom right corner for full screen.
Action Points
• Average-risk adults in the general population who used aspirin regularly for at least 5 years had a lower risk of cancer, myocardial infarction, stroke, and premature death.
• Note that the benefits appeared to increase with the duration of aspirin use but not with the dose.
Average-risk adults in the general population who used aspirin regularly for at least 5 years had a lower risk of cancer, myocardial infarction (MI), stroke, and premature death, according to a comprehensive review of potential benefits and harms.
The relative risk reduction was between 7% for women and 9% for men for all cancer and cardiovascular events combined over a 10-year period. Long-term regular aspirin use was associated with a 4% reduction in the risk of premature death over 20 years.
The benefits appeared to increase with the duration of aspirin use but not with the dose, Jack Cuzick, PhD, of Queen Mary University of London, and colleagues concluded in an article published online in Annals of Oncology.
“It has long been known that aspirin — one of the cheapest and most common drugs on the market — can protect against certain types of cancer, but until our study, where we analysed all the available evidence, it was unclear whether the pros of taking aspirin outweighed the cons,” Cuzick said in a statement.
“Whilst there are some serious side effects that can’t be ignored, taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to implement.”
The most prominent harms of regular aspirin use relate to bleeding, which is associated with several recognized risk factors, he added. As a result, “it would be advisable to consult with a doctor before embarking on daily medication.”
Multiple cohort, case control, and randomized studies have shown that regular aspirin use can reduce the risk of cardiovascular events by 12% in the general population and in high-risk subgroups. A favorable effect on cardiovascular mortality has been more difficult to demonstrate, given the emergence of effective therapies for high-risk patients. More recently, convincing evidence has accumulated to support chemopreventive effects of aspirin on various types of cancer, particularly colon cancer, the authors noted.
Aspirin use also confers a recognized risk of bleeding, which increases with age. Obtaining optimal effects of aspirin requires a balance between risks and benefits, Cuzick and colleagues stated.
In general, previous studies focused on aspirin’s effect on specific outcomes, such as cancer or MI. Organizations that recommend risk-reducing therapies, such as the U.S. Preventive Services Task Force, have not investigated the sum total of risks and benefits for all major diseases.
An earlier study by Cuzick and colleagues showed strong evidence that regular aspirin use afforded protection against colorectal and other types of cancer. However, they concluded that recommending routine use in the general population would be premature at that point.
The investigators revisited the aspirin issue and added new data to the information they had already reviewed. The updated analysis included case-control and cohort studies, as well as randomized trials. They investigated the effects of aspirin on colorectal, esophageal, stomach, pancreatic, lung, prostate, and breast cancer. They also examined aspirin’s effects on the risk of MI and stroke, and they calculated the risk of gastrointestinal bleeding, peptic ulcer, and major extracranial bleeding.
The largest and most consistent benefits were seen in colorectal cancer. The authors reported risk-ratio best estimates for incidence and mortality for the following cancers:
• Colorectal: 0.65 (incidence), 0.60 (mortality)
• Esophageal: 0.70, 0.50
• Gastric: 0.70, 0.65
• Lung: 0.95, 0.85
• Prostate: 0.90, 0.85
• Breast: 0.90, 0.95
The best estimates for MI were 0.82 for incidence and 0.95 for mortality, and for stroke the estimates were 0.95 and 1.21.
The estimated risk of major extracranial bleeding was 1.54 for regular aspirin use. Estimated mortality of gastrointestinal bleeding and peptic ulcer were 1.60 for both outcomes.
Overall, the authors found 10 years of regular aspirin use associated with a 7% reduction in the relative risk of cancer, MI, and stroke among women after 15 years and a 9% reduction in the risk of all events among men. The 20-year mortality benefit was 4%.
In general, clinicians and researchers contacted by MedPage Today gave the study favorable reviews, but none said they were ready to start routine prescribing for average-risk patients.
“What’s clear from this compilation of studies … is there is a very consistent finding, that regular use of aspirin over a period of years will reduce the risk of various types of cancer, including colorectal cancer, perhaps the most prominent to benefit,” said Neal Meropol, MD, of University Hospitals Case Medical Center in Cleveland.
Less clear is the risk associated with regular aspirin use across different types of patients, he added.
The study is a “fascinating” summary of the available data, said Marc Itskowitz, MD, of Allegheny Health Network in Pittsburgh.
“For a high-risk population for bowel and colon cancer, I would strongly consider using aspirin,” Itskowitz said. “However, in general I don’t recommend aspirin for primary prevention. … because we’re concerned that routine use of aspirin might cause gastrointestinal problems, including GI bleeding and maybe even intracranial bleeding.”
Cuzick disclosed relevant relationships with Bayer and QuantuMDx.
One or more co-authors disclosed relevant relationships with Bayer, AstraZeneca, Dr Falk Pharmaceuticals, Boehringer Ingelheim, Sanofi, Bristol-Myers Squibb, Biotronic, Johnson & Johnson, and Servier.
________________________________________
Comment
Primary source: Annals of Oncology
Source reference: Cuzick J, et al “Estimates of benefits and harms of prophylactic use of aspirin in the general population Ann Oncol 2014; DOI: 10.1093/annonc/mdu225.
Daily aspirin ‘cuts bowel and stomach cancer deaths’
By Smitha Mundasad Health reporter, BBC News
Aspirin seems to offer most protection against cancers of the digestive system
Taking aspirin every day can reduce the chance of developing or dying from bowel and stomach cancers, a review of all available evidence suggests.
And scientists predict if everyone aged 50 and above in the UK took the drug for 10 years, some 122,000 deaths could be prevented over two decades.
But they warn aspirin can cause internal bleeding and say medical advice must be sought before using it.
The Queen Mary University of London report is in the Annals of Oncology.
Continue reading the main story
“Start Quote
Taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity”
End Quote Prof Jack Cuzik Queen Mary University of London
Weighing up benefits
Scientists examined some 200 studies investigating the benefits and harms of taking aspirin – an area of continuing medical debate.
They found the drug reduced the number of cases and deaths from bowel, stomach and oesophageal cancer by some 30-40%.
There was weaker and more variable evidence that the drug reduced deaths from breast, prostate and lung cancer too.
And the study found people needed to take the drug for at least five years to see any benefits.
Prof Jack Cuzick, at Queen Mary University of London, who led the research, urged all healthy people aged 50 and above to consider taking a small dose (75mg) of the drug every day for a decade.
Researchers predicted if 1,000 individuals aged 60 took the drug for 10 years, a further decade later there would be:
Prof Cuzick, who has been taking aspirin for four years, said: “Whilst there are some serious side-effects that can’t be ignored, taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to implement.”
Individual risks
They found benefits continued even when people stopped taking the drug, but say it is unclear exactly how long people should use it for.
As the risk of internal bleeding rises as an individual gets older, they suggest a cut-off point of 10 years.
There is still uncertainty whether other doses of the drug could offer more protection.
The benefits of aspirin must be weighed against individual risks, experts warn
Aspirin’s well known possible side-effects include bleeding in the stomach and the brain.
And while the study suggests 122,000 lives could be saved if everyone in the UK aged 50-64 took the drug, this is balanced against the estimated 18,000 deaths from side-effects.
Experts warn anyone at high risk of bleeding, including people with blood disorders who take blood thinning medication, or are frequent smokers or drinkers, are more likely to suffer these side-effects.
They recommend anyone considering daily medication should speak to their doctors to discuss individual risks.
Dr Julie Sharp, at Cancer Research UK, said: “Aspirin is showing promise in preventing certain types of cancer, but it’s vital that we balance this with the complications it can cause.
“Before aspirin can be recommended for cancer prevention, some important questions need to be answered and tests need to be developed to predict who is likely to have side-effects.”
Exactly how aspirin protects against cancer is unknown. Scientists suggest it may reduce inflammation or act on blood cells that would otherwise encourage the spread of the disease.
Do you take a daily dose of aspirin as a preventative measure against bowel and stomach cancer? What do you think about the research into the benefits and risks of taking a daily aspirin? Share your experiences by emailing haveyoursay@bbc.co.uk using the subject line ‘daily aspir
Aspirin should be taken by all over 50s to cut thousands of cancer deaths: study
Every middle aged person should take aspirin daily for ten years, experts have said, as a comprehensive study has found it could save 6,000 lives a year by preventing cancer and heart disease
By Rebecca Smith, Medical Editor
Middle-aged adults should take aspirin every day for ten years, according to scientists who found it could save more than 6,000 lives a year by preventing cancer and heart disease
Daily aspirin can prevent up to one third of cancers of the bowel, throat and stomach and can halve the risk of dying in some cases, according to the the largest, most comprehensive analysis of the drugs use.
It comes after previous research raised concerns about the side effects of aspirin, which include bleeding and ulcers.
The new study found that while there was a small increased risk of a stroke, stomach bleeding and ulcers, the benefits of taking aspirin made it a “good bet”.
Experts said on balance taking aspirin was akin to taking out a pension, in that it was an investment in middle age that provided benefits later.
Advising otherwise healthy middle-aged people to take drugs to prevent later disease has proven controversial with some warning about medicalising old age. The majority of people taking aspirin would not see any benefit nor any harm from it.
Nevertheless the researchers said daily aspirin is now the most important way to prevent cancer after quitting smoking and losing weight.
Everyone aged between 50 and 64 should take a baby aspirin daily for ten years, they said.
This would save 6,518 lives from cancer per year, along with preventing 474 fatal heart attacks, but at the cost of causing an extra 896 deaths from stroke, stomach bleeding and ulcers, it was found.
Over 20 years the net number of lives saved would be almost 122,000 in the UK, the researchers from Queen Mary University of London found.
Anyone at high risk of bleeding should talk to their GP before taking aspirin, Prof Jack Cuzick said, including those on blood thinning drugs, with diabetes or smokers.
He said the benefits of taking aspirin for longer than ten years were more unclear and that the increased risk of bleeding was enhanced in those aged over 70. However the beneficial effects of aspirin last for years after stopping the drug, he added.
Prof Cuzick said: “Whilst there are some serious side effects that can’t be ignored, taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity and will probably be much easier to implement.
“The wise person would do both, improve their lifestyle and take aspirin but you can’t improve your lifestyle to the point that aspirin isn’t necessary.
“If the odds of preventing a death are substantially bigger than causing a death, then I think it is a good bet and at this stage we feel aspirin is a good bet.”
He said the figures included in the analysis were conservative and the benefits may be greater and the harms lower than suggested.
The study was partly funded by Cancer Research UK.
Dr Julie Sharp, head of health information at Cancer Research UK, said: “Aspirin is showing promise in preventing certain types of cancer, but it’s vital that we balance this with the complications it can cause – such as bleeding, stomach ulcers, or even strokes in some people.
“Before aspirin can be recommended for cancer prevention some important questions need to be answered, including what is the best dose and how long people should take it for. And tests need to be developed to predict who is likely to have side effects.
“Given the continued uncertainty over who should take aspirin, Cancer Research UK is funding a number of trials and research projects to make the picture clearer.
“Anyone thinking of taking aspirin should speak to their GP first.”
Prof Cuzick said the recommended dose was 75mg per day and that the risk of internal bleeding associated with aspirin could be cut by around one third by testing and treating anyone found to be carrying the infection, H.pylori in their stomachs.
The study, published in the Annals of Oncology looked at more than 200 research papers of different designs on the effects of aspirin on cancer and heart disease.
It as concluded that for every 1,000 people taking aspirin for 20 years there would be 17 lives saved and two deaths caused.
Several of the authors of the analysis declared that they have worked for the pharmaceutical industry connected to aspirin but that the findings and conclusions in the study do not represent their respective organisations.
