Aspirin use associated with reduction in women’s deaths from any cause over 24 year period
The March 26, 2007 issue of AMA journal Archives of Internal Medicine reported that women who are regular users of low to moderate doses of aspirin had a lower risk of dying from any cause during a 24 year period compared to nonusers. The finding was especially striking for cardiovascular disease deaths.
Andrew T. Chan, MD, MPH, of Massachusetts General Hospital and Harvard Medical School and his associates evaluated data from 79,439 women enrolled in the Nurses’ Health Study, which has been following a group of female nurses since 1976. Participants were free of cardiovascular disease and cancer at the beginning of the study. The women were queried beginning in 1980 and every two years thereafter through 2004 concerning aspirin use. It was determined that there were 45,305 women who were not aspirin users, 29,132 who consumed low to moderate doses (defined as 1 to 14 325 milligram tablets per week); and 5,002 who reported using more than 14 tablets per week.
There were 9,477 deaths up to June of 2004, including 1,991 from heart disease and 4,469 from cancer. Subjects who were current aspirin users had a 25 percent lower risk of dying from any cause, a 38 percent lower risk of cardiovascular disease death, and a 12 percent lower risk of dying of cancer than those that had never been regular users. While the reduction in cardiovascular disease deaths became significant with one to five years of aspirin use, cancer death reduction associated with aspirin did not become significant until at least ten years of use. The decrease in cancer deaths was strongly related to colorectal cancer, although women used aspirin for greater than 20 years appeared to experienced modest reductions in breast and lung cancer deaths.
The authors observed that "Aspirin therapy may influence cardiovascular disease and cancer through its effect on common pathogenic pathways such as inflammation, insulin resistance, oxidative stress, and cyclooxygenase (COX) enzyme activity."
“In summary, our results suggest that, among women, aspirin use at low to moderate doses is associated with a reduced risk of all-cause mortality, largely due to death from cardiovascular disease,” they conclude.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the few agents known to prevent the development of colorectal cancer (Chan TA 2006). Aspirin or NSAID use results in an impressive reduction in the risk of developing colorectal cancer (Janne PA et al. 2000). In two randomized, placebo-controlled trials, aspirin decreased the risk of polyp recurrence, considered a precursor to cancer (Baron JA et al. 2003; Sandler RS et al. 2003); Moran EM 2002; Nakatsugi S et al 1997).
A 9.4-year epidemiological study showed that COX-2 activation was related to more advanced tumor stage, tumor size, and lymph node metastasis, as well as diminished survival rates among colorectal cancer patients (Sheehan KM et al 1999). With regular use of aspirin (a nonspecific COX-2 inhibitor, but also an anticoagulant), the risk of dying from the disease decreased (Thun MJ et al 1991).
Thus, COX inhibitors have a pivotal role in the prevention and adjuvant treatment of colon cancer. However, the benefits observed with taking prescription COX-2 inhibitors such as Celebrex® (100-200 mg taken every 12 hours) for prolonged periods are accompanied by side effects (Tsujii M et al 1998). Therefore, nutritional supplements that naturally suppress COX-2 such as curcumin (3600 mg/day) could be considered (Gescher A 2004); others include bioflavonoids (250 to 1800 mg/day) and silymarin (420 mg/day) (Pares A et al 1998; Boari C et al 1981).
The results of a meta-analysis published in the March 6, 2007 issue of the Annals of Internal Medicine found that regular users of aspirin have a lower rate of colon polyps (adenoma) and colorectal cancer than nonusers.
Canadian reviewers identified 17 studies which sought to determine the preventive effect of aspirin on colorectal cancer, 14 that investigated the drug's effect on colorectal adenoma (which are a precursor of cancer), and 12 reviews of the drug's potential harm. Analysis of cohort studies (which examine a particular population of individuals) determined that regular use of aspirin reduced the risk of colorectal cancer by 22 percent compared with nonusers. One large, long-term study of American women showed that higher doses or the use of aspirin for ten years or more further lowered risk.
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