When aspirin (acetylsalicylic acid) was first recognized by the medical profession over a hundred years ago, it was thought to be something of a miracle drug. It had the effect of lessening or even eliminating pain from headaches, reducing fever and inflammation, as well as lessening the pain of injuries to muscles.

More recently, clinical trials showed benefits in older people in delaying or preventing cancer and heart disease. One study even showed limited effectiveness against Alzheimer’s disease. Perhaps it was a miracle drug after all! Doctors started prescribing aspirin to people over 65, suggesting they take a low dose (baby) aspirin daily as a cheap and easy prophylactic against cancer and heart disease.

A possible downside of regular aspirin use is potential damage to the wall of the stomach and the intestines. Aspirin is a weak acid. Another possible contraindication is that aspirin thins the blood. This interferes with blood clotting and thus may not be good for people with wounds or for people suffering from hemophilia.

Since aspirin use could cause problems, potentially serious ones, when a new study (ASPREE) came out in 2018 that indicated that aspirin use did not reduce mortality in the study population, some trusted medical authorities reversed course and stated that regular aspirin use as a disease preventative was no longer recommended. As a result, many people, including me, ceased daily consumption of low dose aspirin.

The situation is more nuanced than it appeared at first.

• Does a person’s age matter in whether the benefits of aspirin outweigh the risks?
• Does a person’s body mass index (BMI) matter?
• Are there other variables that affect whether aspirin is beneficial?

A new study, examining a large cohort of people has come up with some answers to these questions. The results are given in a paper appearing on the JAMA Network on December 4, 2019 titled “Association of Aspirin Use With Mortality Risk Among Older Adult Participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.”

This study took data from a trial that screened 146,152 Americans aged 55 and over, for four different kinds of cancer. These people were followed up on for mortality. In addition to deaths attributed to the four target cancer types, all-cause mortality was also recorded. Aside from cancer, heart disease is the largest killer of older Americans, so the non-cancer deaths in this study are a good proxy for heart disease deaths.

The study found that aspirin use among people 65 years old and older was associated with a lower risk of mortality, not just mortality from cancer, but all-cause mortality. The hazard ratio for all-cause mortality was 20% lower for consistent users of aspirin than it was for consistent non-users. For all types of cancer, the hazard ratio was 23% lower, and in the specific case of colorectal cancer (CRC) the hazard ratio was a full 38% lower.

This study is based on data from a trial that screened older healthy people for cancer. Anyone showing signs of any disease were eliminated at the outset. The large number of people gives the study significant power.

What should we take away from this? I’ll tell you my takeaway. I am going to resume taking low dose (baby) aspirin daily along with my vitamins and minerals. It’s really a no-brainer. Aspirin is cheap. Bayer’s trademark of the aspirin name reverted to the public domain a long time ago. If I can avoid colorectal cancer or any of the other maladies that bring premature death to people my age, dropping a little acetylsalicylic acid every day seems to be a small price to pay.

BIO:

Allen G. Taylor is a 40-year veteran of the computer industry and the author of over 40 books, including Develop Microsoft HoloLens Apps Now, Get Fit with Apple Watch, Cruise for Free, SQL For Dummies, 9thEdition, Crystal Reports 2008 For Dummies, Database Development For Dummies, Access Power Programming with VBA, and SQL All-In-One For Dummies, Third Edition. He lectures internationally on astronomy, databases, innovation, and entrepreneurship. He also teaches database development and Crystal Reports through a leading online education provider. For the latest news on Allen’s activities, check out his blog at wwwallengtaylor.com or contact him at allen.taylor@ieee.org.