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#13
Baby Aspirin Reduces More Than
Cardiovascular Risk, try Cancer Risk Also
A
once-a-day baby aspirin can modestly ward off the development of
common polyps that eventually grow to become colon cancer, a study
finds.
Many earlier studies have suggested aspirin might be a way to
prevent polyps and cancer, but the new analysis is the first to
put the idea to a rigorous test.
Experts say that while aspirin's benefits appear to be small, it
may still be a reasonable option for those at moderately high risk
of this malignancy, the most common after lung cancer.
"It's clear aspirin will not be a magic bullet," said
Dr. John Baron of Dartmouth Medical School, who directed the
study. "You can't take an aspirin and do nothing else."
The experiment was intended to see if aspirin prevents a
recurrence of polyps after the growths have been removed during
routine colonoscopies. It found the 80-milligram baby aspirin size
taken daily reduces this risk by 19 percent.
The dose is the same one already taken by millions of Americans to
prevent heart attacks. The new work suggests they may be getting
an additional benefit.
Until now, the strongest evidence of aspirin's cancer-preventing
powers came from large population reviews that show regular
aspirin users have only about half as much colon cancer as usual.
However, those reports do not prove that aspirin -- rather than
some other lifestyle habit -- is responsible, so the latest study
was undertaken to see if people given aspirin solely to prevent
polyps truly have fewer of them.
The effect it found is only about half as powerful as the earlier
reports suggested it would be. Nevertheless, even this much
reduction could have substantial impact, considering that colon
cancer is the second-leading cancer killer, responsible for 48,000
deaths annually.
Federal health officials say they are close to recommending that
daily aspirin be considered for people who have polyps removed,
although they are likely to hold off until the outcome of a second
aspirin study is known later this year.
"It's getting to the point where, for patients who are at
moderately elevated risk of colon cancer, aspirin would be a
reasonable option," said Dr. Ernest Hawk, chief of
gastrointestinal research at the National Cancer Institute.
"I will feel more comfortable with this when we have the
results of the second trial."
Baron's study, sponsored by the cancer institute, was presented
last month at a meeting of the American Association for Cancer
Research.
The research was done on 1,121 otherwise healthy men and women in
nine cities who had polyps removed during routine screening. They
were randomly given aspirin or dummy pills.
During repeat screening three years later, the researchers found
that 38 percent of those getting baby aspirin had new polyps,
compared with 47 percent of people getting placeboes. However,
little benefit was seen among those getting full-size aspirin.
Their recurrence rate was 45 percent.
Aspirin interferes with blood clotting and can cause bleeding and
digestive ulcers. "Aspirin does have some real risk, and that
makes me pull back" from a stronger recommendation, Baron
said.
Three large studies are under way to see if Vioxx and Celebrex,
the widely prescribed arthritis pills, can prevent regrowth of
polyps more safely and perhaps more powerfully. These drugs have
action similar to aspirin but are less likely to cause ulcers.
Aspirin, Celebrex, ibuprofen and other nonsteroidal
anti-inflammatory drugs all block production of prostaglandins,
which cause inflammation and appear to fuel the growth of colon
polyps. They may be involved in other tumors as well, including
cancer of the prostate, intestines, breast, skin, lungs, bladder
and tongue.
Hawk hopes the second aspirin study will settle the case for
aspirin. It is being conducted by Dr. Robert Sandler of the
University of North Carolina to check the drug's effect on colon
cancer survivors.
A colonoscopy every 10 years is recommended after age 50. The
screening typically is repeated after three years if polyps are
found. A polyp can grow to a few millimeters in size in a year or
two, but it typically takes 10 or 15 years for them to become
cancerous.
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DID YOU KNOW:
Exercise causes cells to become
more sensitive to insulin, so sugar is taken out of the blood, and
exercising muscles use more sugar. The result is a more normal
blood sugar level.
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