Aspirin increases cancer and mortality — or does it?

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So says this study — can you find anything wrong with it?


Abstract​

Background
ASPirin in Reducing Events in the Elderly, a randomized, double-blind, placebo-controlled trial of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast, prior randomized controlled trials, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality.
Methods
19 114 Australian and US community-dwelling participants aged 70 years and older (US minorities 65 years and older) without cardiovascular disease, dementia, or physical disability were randomly assigned and followed for a median of 4.7 years. Fatal and nonfatal cancer events, a prespecified secondary endpoint, were adjudicated based on clinical records.
Results
981 cancer events occurred in the aspirin and 952 in the placebo groups. There was no statistically significant difference between groups for all incident cancers (hazard ratio
= 1.04, 95% confidence interval [CI] = 0.95 to 1.14), hematological cancer (HR = 0.98, 95% CI = 0.73 to 1.30), or all solid cancers (HR = 1.05, 95% CI = 0.95 to 1.15), including by specific tumor type. However, aspirin was associated with an increased risk of incident cancer that had metastasized (HR = 1.19, 95% CI = 1.00 to 1.43) or was stage 4 at diagnosis (HR = 1.22, 95% CI = 1.02 to 1.45), and with higher risk of death for cancers that presented at stages 3 (HR = 2.11, 95% CI = 1.03 to 4.33) or 4 (HR = 1.31, 95% CI = 1.04 to 1.64).
Conclusions
In older adults, aspirin treatment had an adverse effect on later stages of cancer evolution. These findings suggest that in older persons, aspirin may accelerate the progression of cancer and, thus, suggest caution with its use in this age group.
 

schultz

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The study seems straight-forward. The effect is not huge, but it does seem to indicate a slight increase in cancer after 4 years. I didn't read the paper word for word, but read a good amount of it.

I'd like to see a similar study with an increased dose + supplemental K (the control would have to get K as well)

I wonder if they matched the excipients in the aspirin and placebo group? Just a thought...
 

ecstatichamster

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There are a number of studies showing that aspirin has a profound benefit in preventing cancer and also in slowing its progression.
 

Gustav3Y

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Salicylate toxicity in elderly patients with rheumatoid arthritis​


Abstract​

Using the American Rheumatism Association Medical Information System, we studied the effect of age upon salicylate toxicity in elderly patients with rheumatoid arthritis. Data were gathered from 545 patients by self-reported questionnaires for the 6 months and also the 7 days before the visit of interest. With one week data and weight adjusted doses in 253 patients in whom data were available, age related differences in lower gastrointestinal symptoms (p = 0.05) and tinnitus (p = 0.01) were found, despite the fact that elderly patients (E) took less salicylate than younger ones (y)--E [39.1 +/- 2.4 (SD) mg/kg/day] vs Y [49.8 +/- 3.89 mg/kg/day] (p = 0.02). Our data indicate a difference in salicylate dynamics among the elderly (i.e., increased toxicity in the face of decreased salicylate doses).


 

Mito

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There are a number of studies showing that aspirin has a profound benefit in preventing cancer and also in slowing its progression.
True but there are also a number of studies that show it is not.

Conclusions​

From the available evidence, our data indicated that compared with no aspirin, the long-term use of aspirin in individuals without pre-existing cancer was not associated with a reduction in total cancer incidence, cancer mortality, or all-cause mortality; however, aspirin use was associated with a significant increase in the risk of bleeding in this population. Therefore, aspirin might not be an appropriate choice for the primary prevention of cancer. Prospective RCTs of the role of aspirin in primary cancer prevention are warranted.
 

Missenger

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Mar 15, 2018
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Chinese authors on whose payroll?
They seem pretty supportive for it for most of the studies relating to cancer and then a couple of them sound like they say the exact opposite recently, just looking at the two names on the list.
 

JKX

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Apr 18, 2018
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Ah, the good old 'self reported questionnaire'. Pass.

Enteric coated aspirin. Pass.
 

GAF

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High Aspirin plus high salt = much less pain and eventually much less Aspirin. Try it. You'll like it.
 

LucyL

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Oct 21, 2013
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Almost all low-dose aspirin is enteric coated by a toxic mix of chemicals. The question is, is 81 mg of aspirin enough to offset the toxicity?
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