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An aspirin a day keeps cancer at bay
Confluence of 3 studies

Saturday » March 8 » 2003


Brad Evenson 
National Post


Thursday, March 06, 2003

New research on Aspirin, a centuries-old drug once extracted from willow bark, shows a single pill a day dramatically cuts the risk of cancer.

Doctors already recommend the drug to protect the heart, prevent strokes and reduce the pain from arthritis. But three new studies, two published today in the New England Journal of Medicine, demonstrate the drug also has potent anti-cancer properties.

In one of two U.S. studies of patients with previous colorectal cancer, 37% fewer patients who took Aspirin developed adenomas compared to patients who got placebos. Adenomas are precursors to cancer and are often called polyps.

The benefits were so striking the study was halted early so all the patients could take the medicine.

''From both animal research and observational studies, we've recognized for a long time that Aspirin might decrease the risk of colon cancer,'' said Dr. Robert S. Sandler, the study's principal investigator.

''To find out whether Aspirin really worked, we needed a randomized trial where we could compare Aspirin with a placebo.''

In a separate finding, Italian scientists reported in the British Journal of Cancer this week that taking Aspirin for five years cuts the risk of cancers of the mouth, throat and esophagus by two-thirds. The researchers say if people started taking the drug earlier, specifically for its anti-cancer properties, it might be possible to achieve even stronger protective effects.

''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,'' said lead researcher, Cristina Bosetti of the Institute of Pharmacological Research in Milan.

Scientists began looking at Aspirin as an anti-cancer agent in the early 1990s, when they found regular users, such as arthritis sufferers, had less cancer than usual. The current studies are the first large-scale trials to provide direct evidence that Aspirin was responsible.

Previous studies using drugs, dietary fibre or vitamins to prevent adenomas have not had a significant effect.

Aspirin works by blocking an enzyme called COX-2 that controls inflammation.

This enzyme is also produced by colon tumours, leading to faster cell growth, increased capacity to invade healthy tissue and growth of new blood vessels to feed tumours. Drugs such as Celebrex and Vioxx, which also inhibit COX-2, have also shown signs of being cancer fighters and studies are now being conducted.

''The good news is that ... sometimes, the best chemopreventive agents are close at hand, and relatively inexpensive,'' said Electra Paskett, co-author of one study and associate director of population sciences at the Ohio State University Comprehensive Cancer Center.

In the first study, 719 patients with a history of colorectal cancer were observed from 1993 to 2000 in hospitals across the United States. Among those who took a daily, 325-milligram dose of Aspirin, 17% developed adenomas compared with 27% in the placebo group.

In the second study, 1,100 patients with previous colorectal polyps were studied from 1994 until 2001. Patients got either a baby Aspirin of 81 mg, or 325 mg, or a placebo. Interestingly, the group receiving the baby Aspirin showed a lower incidence of recurring polyps than did those treated with the larger dose.

According to the National Cancer Institute, an estimated 17,600 Canadians were diagnosed with colorectal cancer last year and 6,600 died of the disease. Since the studies show Aspirin protects against pre-cancerous polyps, it probably also reduces the rate of colorectal cancer itself.

Researchers said although Aspirin is a safe drug, patients should consult a doctor before taking it every day and should get regular checkups.

''Aspirin is not a magic bullet,'' said Dartmouth Medical School researcher John Baron, author of the second study.

''Although the incidence was reduced, all the polyps didn't go away in our study. Regular screenings, perhaps including colonoscopies, are still important.''

bevenson@nationalpost.com

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