Aspirin may be a mediocre painkiller, but scientists have recently learned that it may have other intriguing health benefits.
Many people already take aspirin to lower their risk of cardiovascular disease. And now there's firm evidence that aspirin can help reduce the risk of heart attacks and colorectal cancer in certain high-risk groups. It's not recommended for everyone, but it could help a small subset of at-risk patients.
The US Preventive Services Task Force, a group of independent medical professionals who analyze the best available evidence to create guidelines for doctors, published their draft guidance on aspirin this week. This is the first major medical organization to suggest that some people should consider taking the drug to reduce their risk of cancer. Briefly, here's what the task force found:
- People in their 50s who are at an increased risk of cardiovascular disease might want to consider taking low-dose aspirin to help prevent heart attacks and strokes, as well as colorectal cancer.
- The group they're recommending take aspirin daily is very narrow, however: "Adults ages 50 to 59 years who have a 10 percent or greater 10-year [cardiovascular disease] risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years."
- For people in their 60s, the benefits of aspirin appear to be smaller, in part because the risk of bleeds in this group is higher. For those people, the task force says, advice on taking aspirin should be individualized, since the evidence is too mixed to make broad recommendations. (And there's not enough clear evidence on the benefits of aspirin for older folks or people younger than 50.)
- Because aspirin prevents blood clot formation — which causes heart attacks and some types of stroke — it can also increase the risk of bleeding. So this means anyone who has, for example, a history of stomach ulcers and who wants to take aspirin for prevention needs to balance the heart and cancer benefits they'd get with the bleeding risk.
So it's important to note that this advice is very narrowly tailored. Many people who currently take aspirin may not glean any benefit at all, especially if they're not in a higher-risk category for cardiovascular disease and colorectal cancer.
But for those who are at risk, aspirin can have a pretty significant effect. "In a group with elevated cardiovascular risk, aspirin may prevent as many as 25 to 30 heart attacks per 1,000 people over 10 years," explained Michael Hochman, an internist who recently authored a book on evidence-based medicine.
Likewise, the task force points out that aspirin reduces the risk of colorectal cancer by as much as 40 percent in some.