If aspirin is a miracle, should we all take it?

March 22, 2012 by
Health   No Comments Yet

So, did you take a mini-aspirin this morning? If not, why not? Research appears to confirm aspirin’s growing reputation as that most medicinal of clichés – a miracle drug. The study, published on Tuesday, reported that taking a low dose of acetylsalicylic acid – the generic name for aspirin – daily for between three and five years reduces the chance of being diagnosed with cancer during that time by 19 per cent.

The research, by Oxford University’s Stroke Prevention Research Unit, and published in The Lancet, also found that five years or more after starting taking aspirin, the reduction in cancer diagnoses rises to 30 per cent, and that the drug appears not only to stop cancers developing but also to stop them spreading. From its accepted status as a useful painkiller with a particular benefit for patients with a history of heart disease or stroke, it seems aspirin could be a prophylactic for us all. Indeed, this research is the tip of a mountain of evidence that ought to be visible from space.

Previous work by the same group has shown that taking 75mg of aspirin – a  quarter of the standard over-the-counter pill – daily for five years or more reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third.

We also know that aspirin thins the blood through its effect on platelets, which is why it is prescribed for people with cardiovascular disease, and for those at risk of it because of high blood pressure, diabetes or their family history. Moreover, aspirin is used widely for blood-clotting disorders and to help prevent recurrent miscarriages, migraines, cataracts, and pre-eclampsia pregnancy.

So shouldn’t every middle-aged man or woman (in whom the drug is not contraindicated) be taking it every morning?

One of the UK’s leading cancer specialists, Prof Karol Sikora, says the prophylactic evidence is certainly positive, but that he doesn’t take a daily aspirin – yet. ”I don’t actually know why not,’’ he admits, sheepishly.

He’s not alone among British doctors. At a recent cancer conference in the US,   he asked an audience of specialists whether they took aspirin. ”Sixty per cent raised their hands; at a similar event in the UK, only 5 per cent said they took it daily.” The reason? ”Americans are proactive about their health care,’’ he says.

The side-effects associated with regular aspirin intake remain a factor. ”There are always gastrointestinal side-effects such as stomach bleeding and pain, and no one can remove these risks,” says Prof Sikora. “If you have no history of ulcers or gastritis, you could probably go ahead – but if after a week or two you feel stomach discomfort, talk to your GP.’’

And quantity is not quality, he says. ”There is no added benefit to taking higher doses when it comes to preventing disease – but there is more risk of   side-effects. Stick to a junior [75mg] dose.’’ (Although ”junior’’ is a misnomer, as aspirin should never be given to under-16s unless under specialist advice – it can cause the potentially fatal Reye’s syndrome.)

In addition to peptic ulcers, other contraindications include haemophilia or bleeding disorders, and allergies to aspirin or to non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac. It should be taken with caution by those with asthma, liver, kidney or digestive problems, while pregnant and breastfeeding women should seek advice from their GP.

So at what age should you start? Dr Sovra Whitcroft, a consultant gynaecologist at the Surrey Park Clinic, Guildford, thinks all women of  menopausal age or older should be taking a low daily dose. ”Aspirin is known to reduce risk of cardiovascular disease, including [vascular] dementia, possibly due to its effect in thinning the blood and reducing the   chance of microscopic clots in the blood vessels. And the risk of developing cancer also increases as oestrogen levels decline.’’ Cancer is, of course, age-related, which is why aspirin as a prophylactic drug is something men in middle age should consider, too.

Even Prof Sikora? ”I am wavering now. I think I’ll go and read that Lancet  paper again.’’

About the Author

Victoria Lambert has been a journalist for more than 20 years, and specialises in health and medical matters. She writes for the Telegraph, the Times, the Sunday Times, the Guardian, the Mail and the Mail on Sunday. She contributes to Saga, Geographical and First Eleven magazines – where she is the agony aunt.

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