Aspirin and colon cancer prevention

Over the past number of years, evidence has emerged supporting the potential role of aspirin in the prevention of colorectal cancer.  In aggregate, the data is still not robust enough to make routine aspirin therapy a mainstream recommendation, especially given the side effects of the medication and the increased potential of dangerous GI bleeding and/or strokes. However, the July 16, 2013 edition of the Annals of Internal Medicine published a report based on the Women’s Health Study, which randomized its subjects into no aspirin, and low dose every other day, subgroups. Women in the study were 45 years or older, and had no history of cancer, heart disease or other major chronic illness,

Closely followed for an average of ten years, patients receiving every other day aspirin treatment had no difference in total, breast, or lung cancer.  On the other hand, colon cancer was decreased by 20% in the treatment group. This was accompanied by an increase in ulcers and bleeding in relation to the aspirin cohort.

Aspirin is already considered standard of care for patients with known coronary artery disease; its use to prevent heart attacks in patients simply at risk for such events is a little more complicated. With the data from the Women’s Health Study adding more evidence to the “pro aspirin treatment” camp, we are likely to see ongoing refinements and updates (and confusion) over the best use of this inexpensive over the counter therapy.  However, it cannot be overemphasized that aspirin is NOT a benign treatment and the weighing of the risks and benefits of long term, regular treatment is best done in conjunction with your primary care provider