Home
Bupa members

Support and offers for individual members and customers

Could aspirin reduce cancer risks?

Bupa investigative news - 17 March 2003
written by Rachel Newcombe, reporter for Bupa's Health Information Team

Three recent studies report that the painkilling drug aspirin could help in the battle against various forms of cancer, namely throat, mouth, oesophagus and bowel. But is it a good idea to take aspirin as a preventive measure or should we wait for further investigations to be completed?

KEY POINTS

Every year in the UK there are approximately 35410 new cases of colorectal (bowel) cancer.

Each year in the UK there are roughly 7250 new cases of oesophageal cancer, 4000 of mouth cancer and 2200 of throat cancer.

Three studies looked at the possibility that aspirin could help reduce the risk of cancer - of the mouth, throat, oesophagus and bowel.

An association was found between aspirin use and reduction of cancer risk.

Although interested in the research, experts say further investigations are required before firm conclusions can be drawn. At the moment, they warn against taking aspirin of your own accord, as it may cause side-effects such as stomach ulcers and bleeding.

What were the headlines?

Aspirin hit the headlines with the news that it could be useful as a potential preventive measure for cancers of the throat, mouth, oesophagus and colon. A selection of headlines included, "Now aspirin can help fight cancer", "Aspirin 'stops five cancers'", "Aspirin hailed in battle to fight off risks of mouth and throat cancer", "Aspirin can 'cut the risk of cancer'", and "Is humble aspirin the wonder drug of the 21st century?".

What is the bigger picture?

Three studies were published that looked at the association between aspirin and mouth, throat, oseophageal and colorectal (bowel) cancers. The first study was by scientists in Italy's Institute of Pharmacological Research in Milan who looked at mouth, throat and oesophageal cancer. They combined and re-analysed data gathered from three separate studies, involving 965 cancer patients and 1779 people in hospital for other conditions. All the participants completed detailed questionnaires concerning their smoking and drinking habits, diet and aspirin use.

The results, published in the British Journal of Cancer, showed that people who took aspirin regularly for five years were two-thirds less likely to develop cancers of the mouth, throat and oesophagus when compared with non-aspirin users. Many of the people studied were taking the drug on medical advice to treat long-standing conditions such as heart disease.

Dr Christina Bosetti, who led the research said, "This is the first quantitative evidence that taking aspirin may reduce the risk of developing cancers in what we call the aerodigestive tract, connecting the mouth and the stomach."

"We think that aspirin may take effect by acting on an enzyme called cyclooxygenase-2, which has a role in both inflammation and the process of cancer growth," she explained. "Our results further extend our knowledge of the health benefits of this remarkable drug and suggest that taking it could become an important way of protecting ourselves against cancer."

The other two studies investigated the effect of aspirin on colorectal cancer risk and were published in the New England Journal of Medicine. Although the two studies were primarily based at different locations in America, they involved some of the same researchers.

At the Norris Cotton Cancer Center and Dartmouth-Hitchcock Medical Center in New Hampshire the researchers found that taking daily aspirin may be effective in reducing the risk of colorectal adenomas. These are benign tumours (also known as polyps) that can sometimes develop into cancer if they remain in the bowel. In this study 1100 patients who'd previously been diagnosed with colorectal adenomas were either given 81mg or 325mg (standard adult dose) of aspirin, or a placebo.

Both groups who were given aspirin had a lowered risk of developing polyps when compared with those given placebo. The people who took the lower dose of aspirin fared the best, with a 19 per cent reduced risk of polyps recurring and more than 40 per cent lower risk of developing advanced lesions when compared with placebo.

The second study, based at the University of North Carolina, randomly assigned 635 previous sufferers of colorectal cancer to either an aspirin or a placebo group. Those taking aspirin were given 325mg per day and were found to have a 35 per cent lower risk of developing polyps in their colons than those who took the placebo.

Researcher Dr Richard Schilsky said, "Aspirin had a significant protective effect. It clearly reduced the formation of polyps in this study of high-risk individuals, which is good news because it provides a new way to lower the risk of recurrence in patients who have had colon cancer."

According to Dr Robert S Sandler, who was involved in both studies, "We've recognised for a long time that aspirin might decrease the risk of colon cancer." He admitted that the contradictory results regarding the dose of aspirin may be confusing, but said, "I would simply conclude that the two studies provide strong evidence that aspirin is protective and less guidance about the best dose."

He added that the findings are, "Good news and encouraging, but they don't mean that people can assume they can protect themselves completely from colon cancer. We are not suggesting that even those with increased cancer risk take aspirin until they have discussed it with their doctors."

“This is really interesting research, but it's too early to encourage people to take regular aspirin. We already know that aspirin has clear health benefits for many people, but it can be dangerous - even lethal - for others. The drug can cause stomach irritation, ulceration and bleeding, particularly when taken over a long period. Although symptoms such as these can be reduced with additional stomach-protective medication, often people taking them are not aware that the drug may be causing more harm than good. As a result, it is not a drug to be taken on a regular basis without prior discussion with your doctor.”

Dr Sally Cubbin,
assistant medical director
Bupa Membership

What does this mean?

Bupa Membership's assistant medical director, Dr Sally Cubbin, described the studies as "interesting", but said it's far too early to suggest aspirin should be used for cancer prevention or that people should start taking the drug. In regards to the study which examined throat, mouth and oesophageal cancer, she said, "The biggest flaw is that their definition of regular use is unclear and too broad - it includes people who took aspirin every day and those who took it three times a week. That's a huge variation."

Dr Richard Sullivan, head of clinical programmes for Cancer Research UK, agreed. "We're not yet at the stage where we can recommend that everyone starts taking aspirin on a daily basis, as we'll need to further investigate its effectiveness and possible side-effects of long-term use," he said. "However, it looks as though the drug could become an important part of cancer prevention."

Rob Glynne-Jones, a medical expert from Colon Cancer Concern, said, "These are exciting times and the research that has been done into the benefits of aspirin is very encouraging. A major study is currently underway in the UK, called the Victor study. This study is taking place in patients who have undergone successful surgery for colorectal cancer to find out if a more modern derivative of aspirin can help to prevent the cancer from recurring. Hopefully, in the future, we will have a medicine that will prevent this disease from returning."

ACTION POINTS

Don't take aspirin on a regular basis, unless your doctor has instructed you to do so.

Be aware of the warning signs of cancers (see the lists below). If you notice anything of concern, consult your GP.

Warning signs of mouth, throat and oesophageal cancers include:

  • A lump or long-standing ulcer in your mouth
  • A feeling that something's constantly caught in your throat
  • A very sore throat or hoarse voice that won't clear
  • Difficulty chewing or swallowing
  • Numbness in the mouth or on the tongue
  • Swelling on your jaw
  • Difficulty moving your jaw or tongue
  • A red or white patch on your tongue or in your mouth
  • Soreness in your mouth, which won't heal

Warning signs of colon cancer include:

  • A change in bowel habits
  • Blood in the stools
  • Pain or discomfort in the stomach
  • Unexplained weight loss
  • Extreme tiredness

Don't give aspirin to under 16-year-olds. The Medicines Control Agency advises that this is because it's been shown to be linked to a rare, but potentially fatal, condition called Reye's Syndrome which affects the brain and liver.

What does this mean to me?

According to Dr Sally Cubbin, the most important thing is not to start taking aspirin on a regular basis of your own accord, as it does have adverse side-effects. If you want to reduce your risk of cancer, a safer method is to focus on diet and lifestyle approaches.

"Heavy drinking and smoking increases the risk of mouth, throat and oesophageal cancers," she said, "And poor dental hygiene is a risk factor for mouth cancer." Dr Cubbin also pointed out that colon cancer is associated with a low intake of fruit and vegetables and obesity, so altering these habits could be beneficial.

Cancer Research UK agreed, adding that it's also helpful to be aware of - and on the lookout for - signs of cancers. In the case of mouth, throat or oesophageal cancers, this includes things such as an inability to swallow or chew properly, a mouth sore that won't heal and a very sore throat that won't clear.

Likewise, being aware of potential signs of colon cancer, such as a change in bowel habits or blood in your stools, is crucial too, said Colon Cancer Concern.

Summary

The research into the potential of aspirin for aiding cancer is undoubtedly interesting, but for the moment no definite conclusions have been reached and further investigation is necessary. Most importantly, it isn't advisable to take aspirin regularly without guidance from your doctor.

Links for more information

 

Bupa health insurance

Bupa health checks