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An Aspirin a Day? Study Suggests Dose Might Reduce Risk of Colon Cancer

Posted on: Saturday, 24 September 2005, 12:00 CDT

Richard Johnson probably owes his life to his wife, Linda.

About six months ago, he began having some chest discomfort, and his wife said he should begin taking aspirin daily. Earlier this month, doctors found a major artery blocked in his heart, requiring a stent.

"Come to find out, when I went and met with my doctor, he said that's probably what saved my life," Mr. Johnson said, as he tried to cool down after a workout at University Hospital Cardiopulmonary Rehabilitation. Should he continue his daily dose of regular aspirin for a decade, there might be even more good news - it could help reduce his risk from colon cancer.

A long-term study of nurses found that those who took regular doses of two aspirin a day over at least 10 years had lower rates of colon cancer, with the risk decreasing as the dosage increased, according to a study published today in the Journal of American Medical Association.

Those who took the highest dosage, more than 14 tablets a week, had half the rate of colon cancer as those who took no aspirin. The study found no benefit from relatively small doses, such as those prescribed for heart disease patients, or for those who took it less than 10 years.

But not all the news is good.

The report, based on the Nurses' Health Study that has followed 120,000 female nurses since the 1970s, also found a pronounced risk for gastrointestinal bleeding that increased with the dosage. Those at the highest dosage also had nearly double the risk of bleeding.

"There is a balance between the GI bleeding at this dose and the protective effects," said vascular biologist John Imig at Medical College of Georgia.

It suggests weighing one against the other, said Dr. Lawrence J. LaHatte, of Gastro-enterology of Augusta.

"We may end up down the road with is a subset of patients that we feel like the risk/benefit ratio is there, especially those with a family history, (or) a prior history of polyps," he said. But it might not be worthwhile for the general public, he added.

The study authors noted that while taking aspirin regularly over a certain period of time, for every one to two colon cancers prevented there would be eight cases of bleeding.

"Certainly you can't recommend that everyone start taking 14-16 aspirin a week," said Michael Shlaer, of Medical Oncology Associates. "The issue of the risk needs to be sorted out before some general recommendation about who, if anybody, should get these drugs to reduce their risk of colon polyps or colon cancer."

The study also found the same benefits for nonsteroidal anti- inflammatory drugs, such as ibuprofen, with the benefits increasing as the dose increased. However, those risks of bleeding at higher doses were even greater than aspirin produced.

The COX-2 inhibitors, such as Celebrex, appeared to more selectively target the enzyme thought to aid cancer growth, but at higher doses those drugs produced more heart attacks, Dr. Shlaer said.

A jury last week blamed one COX-2 inhibitor, Vioxx, for the death of a Texas man.

"Really what it suggests is there is another target there" for drug development, Dr. Imig said.

Reach Tom Corwin at (706) 823-3213

or tom.corwin@augustachronicle.com.

Source: Augusta Chronicle, The

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