where the scientific evidence points pretty convincingly to the potential health benefits of long-term regular aspirin use outweighing the potential risks for most people. That's the conclusion of a new analysis appearing last week in the Annals of Oncology.
While the heart attack and stroke benefits of aspirin use, especially in those at high risk of such events, has been accepted for years, the cancer prevention benefits have been slower to catch on - even though the evidence for colon cancer prevention alone has been quite convincing.
This new analysis confirms the cardiovascular benefits of aspirin use while solidifying its benefits in both preventing and lowering mortality for colorectal, esophageal, and stomach cancer - and possibly for breast, prostate, and lung cancer.
Bleeding is the main concern with regular aspirin use, and the analysis found - not surprisingly - that the risks of events such as bleeding strokes (hemorrhagic strokes) and GI (gastrointestinal) bleeding go up with regular use.
However, after looking at all the benefits and risks together, the researchers found that use of a daily 75 - 325 mg aspirin for 5 or more years starting between ages 50 - 65 years had overall positive benefits.
After 10 years of use, risk of cancer, heart attack, and stroke was 9 percent lower in men and 7 percent lower in women after 15 years. Lower rates of cancer made up the large majority of this benefit, with colon cancer by itself making up about a third of the total benefit from aspirin use. Taking the risks of bleeding events into account, the overall health benefit dropped to about 6 percent for men and women. Lower but still overall positive.
Of course there are still many unanswered questions about the best approach to aspirin use. Because risk of bleeding goes up with age, it's unclear at what age people should stop taking aspirin because the risks outweigh the benefits. Figuring out the best way to identify people at risk of bleeding issues is another important topic, as is the best dose to use. While there's good evidence that a low-dose baby aspirin provides most if not all the benefits of, and likely has fewer risks than, a higher dose 325 mg aspirin, there are not yet definitive studies that have looked at the issue.
While anyone interested in starting on daily aspirin should first talk with his or her doctor, the data are now clearer than they've ever been that such use is likely to have real and lasting health benefits for most people.
Related post: Evolution of the Science on Aspirin Use and Colon Cancer Prevention