Cancer: Aspirin May Reduce Colon Cancer Risk

In a groundbreaking study, aspirin – an everyday pain reliever – reduced colon cancer by 50 percent. The international trial – known as CAPP2 – involved patients with Lynch syndrome from around the world and revealed that two aspirins a day, for an average of two and a half years, reduced the rate of colon cancer by half. Lynch syndrome is a type of hereditary cancer syndrome that is associated with a genetic predisposition to several types of cancer.

The study, led by experts from the Universities of Newcastle and Leeds, published in The Lancet, is a planned 10-year double-blind follow-up supplemented in more than half of the recruits with comprehensive national cancer registry data for up to 20 years.

Professor Sir John Burn, from Newcastle University and Newcastle Hospitals NHS Foundation Trust, who led the research, said the findings further support this important guideline.

He said: “I had this idea 30 years ago that people with a genetic predisposition to colon cancer could help us test whether aspirin could really reduce the risk of cancer.

“Patients with Lynch syndrome are at high risk and this provided statistical power to use cancer as an endpoint – they are like the canaries in the mine who warned the miners there was gas.

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“It took a long time to start the trial and recruit enough people in 16 countries, but this study finally gave us an answer.

“Two aspirins a day for a few years gives protection that lasts for more than 10 years and the statistical analysis has become much stronger over time.

“For people at high risk of cancer, the benefits are clear – aspirin works. Our new international trial, CaPP3, will see if smaller doses work just as well.”

Findings showed that when all original recruits were included in the study, those taking aspirin had a 42 percent reduction in colon cancer.

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Among those who took the aspirin for two years, there were a 50 percent reduction in colon cancers.

The study included 861 patients with Lynch syndrome, which affects approximately one in 200 people in the population. These people have a genetic problem with DNA repair, which puts them at much higher risk for cancers such as colon and uterus.

A group of 427 were randomized to aspirin continuously for two years and 434 were assigned to a placebo and then all were followed for 10 years. Of those given two aspirins (600 mg) each day, 18 had fewer colon cancers, representing a 42.6 percent decrease.

When all 163 Lynch syndrome cancers were included in the analysis — such as cancers of the endometrium or uterus — there was an overall reduced risk of cancer of 24 percent in those who took aspirin, or 37 percent in those who took aspirin for the full two year .

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Professor Sir John said: “Aspirin has an important preventive effect on cancer, but this only becomes apparent four years later. With the help of these dedicated volunteers, we have learned something of value to all of us.

“Before anyone starts taking aspirin on a regular basis, they should consult their doctor first, as aspirin is known to carry a risk of stomach upset, including ulcers and bleeding.

“However, if there is a strong family history of cancer, people may want to weigh the costs and health benefits of taking aspirin for at least two years.”

What Cancer Research UK Says

There is some evidence that aspirin may help lower the risk of:

  • get some cancers
  • Cancer is spreading
  • People who die of cancer.

“But at this time there are no national guidelines for the general population to take aspirin to prevent or treat cancer,” notes the charity.

Cancer Research UK also points out the potential risks of taking aspirin: “There are risks to taking aspirin, as with all medicines. It can cause serious side effects for some people, such as internal bleeding.

“There are also other reasons why some people cannot take aspirin, for example because of other health problems (contraindications).”

As the charity explains, some people with cancer already have a higher-than-normal risk of bleeding. Others may have a higher risk of developing blood clots.

What does Cancer Research UK recommend?

“Talk about the risks with your doctor if you’re considering taking aspirin.”

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