Aspirin & cancer survival

Executive summary

* Low dose aspirin has been the subject of much research in the fields of cancer and cardiovascular disease. It has been studied for potential prevention and help post diagnosis.

* This week's note examines a very large systematic review and meta-analysis of 118 studies, which reviewed aspirin for cancer post diagnosis.

* Significant reductions (approximately 20%) in mortality were found in patients taking aspirin for some of the most common cancers and other cancers when grouped together.

* The paper summarised some findings on extension of median survival following cancer diagnosis, which is the way in which cancer data are presented. Some of the numbers on possible life extension among patients taking aspirin were impressive.

* The mechanisms were not explored in this paper but were explored in another paper by the lead author. The mechanisms are plentiful and plausible.

* The one downside of taking aspirin is the risk of bleeding. This note reviews the evidence for the risk of bleeding and tries to put possible benefit and risk in context with each other.

* There is no evidence that aspirin will increase the risk of fatal bleeds and so the concern that possible life extension may be offset by a fatal bleed is not warranted.

* The authors concluded that the evidence should be shared with patients and their carers so that they can make an informed choice about whether to add aspirin to their cancer treatment. I agree with this conclusion.


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