Taking low-dose aspirin is associated with 20% reduction in cancer deaths

[breadwinner]

This has to be balanced against this news: "Daily low dose aspirin increases brain bleeding risk by 38% in older adults." See: https://www.medicalnewstoday.com/articles/low-dose-aspirin-r...

[alejohausner]

Brain bleeding is very rare. That 38% number is a *relative risk ratio*. I'm always wary of studies that use such ratios to make an effect seem large. The following excerpts from the article you cited state:

For the study, the researchers analyzed data from 19,114 adults with an average age of 74 years old.

Altogether, 1.1% of those taking aspirin (108 individuals) experienced intracranial bleeding, while the same was true for 0.8% of those taking a placebo (79 individuals).

[tagrun]

It says in older adults.

This is a meta-study, touching on that "contrast" already: there is a subsection in the paper dedicated to this, where they claim that

"The major factor in cerebral bleeding however is hypertension, and in an RCT of aspirin based on more than 18,000 hypertensive patients—all of whom were receiving ‘optimal’ antihypertensive treatment—there were no additional cerebral bleeds in patients randomised to aspirin" (Refs 46 and 47).

which seems to be in contradiction with the article corresponding to the news you linked to: https://jamanetwork.com/journals/jamanetworkopen/fullarticle... and strangely doesn't cite or comment on Refs 46 and 47 from the paper of the main thread, possibly because they don't seem to be focusing on older adults.

There is also a subsection on gastrointestinal bleeding.

Intracranial bleeding isn't necessary something that cause permanent damage, or lethal by the way.

[enasterosophes]

Aspirin is also associated with gout. I'm not sure if the dosage required to worsen gout is lower than the dose discussed in the paper. I merely caution that anyone thinking about increasing their aspirin usage to prevent cancer should consult a GP first, since it's complicated, and anyone who has had gout probably doesn't want to increase their rate of flare ups.

[DoesntMatter22]

It should be noted that you can get a lot of aspirin from vegetables, which also contain aspirin.

This video talks about a similar study and the plant foods that have highest doses of aspirin, all without stomach bleeding.

https://www.youtube.com/watch?v=BcmoILbgmwc

[hammock]

Which is worse?

[nradov]

Yes, we need to see a long-term study of all cause mortality before recommending this intervention for primary prevention.

[darkerside]

100% reduction in cancer deaths in those with self inflicted gunshot wounds to the head

[mcdonje]

I was curious about possible mechanisms, so I followed the link to the paper and was pleased to find they're discussed.

https://www.nature.com/articles/s41416-023-02506-5

[Leary]

This is a meta analysis of observational studies. There's random controlled trial which showed all cause mortality was 14% higher for "healthy older adults who received daily aspirin than among those who received placebo"

https://www.nejm.org/doi/full/10.1056/nejmoa1803955

[noodlenotes]

The meta analysis is studying asprin as a cancer treatment, so the subjects were patients who already had cancer, not healthy adults taking it as a preventative. Daily asprin could both be bad for healthy adults and good for cancer patients.

[strangescript]

Probably more like lower inflammation reduces all cause mortality.

[ehnto]

I wonder if this is a reduction in mortality that was caused by an increase in chronic inflammation from modern life, stress and obesity.

In a healthy fit human, inflammation is a good thing, it is the body's construction and maintenance crew. Chronic inflammation is not good, but that is a side effect of an underlying issue (in my understanding so far)

[jjtheblunt]

There’s detailed but clear explanation in the paper that it’s doing anticancer things not related to reducing inflammation.

[kazinator]

People who are diligent to keep taking an aspirin pill day in and day out even though they are not sick are likely sufficiently worried about their health to also subject themselves to timely cancer screening.

[stvltvs]

This is a study of cancer patients, not the general population.

[rattlesnakedave]

Reminds me of Ray Peat: https://raypeat.com/articles/aging/aspirin-brain-cancer.shtm...

Disclaimer: A lot of his stuff is pretty out there, and some of it may be outright wrong. I don’t recommend following his advice, but a lot of his writing is at least interesting.

[diziet]

https://www.youtube.com/watch?v=gcR2k4Olhms Aspirin Alert: The Hidden Risks Revealed Dr Brad Stanfield

[1letterunixname]

Low-dose aspirin shouldn't be taken blindly. There was also hope triflusal was going to be safer than aspirin, but it's didn't do much better either.

https://www.stroke.org/en/life-after-stroke/preventing-anoth...

https://n.neurology.org/content/62/7/1073

https://pubmed.ncbi.nlm.nih.gov/29866011/

[didntknowya]

although indiscriminate long term aspiring can cause GI side effects

[01100011]

Increases risk for hemorrhagic strokes as well. AFAIUI, your clotting ability is impaired, so if you get a minor bleed, it's not minor for long.

IIRC, the recommendations to folks taking aspirin for heart attack prevention is "don't, unless you've already had an ischemic event" because the risk outweighs the benefits for everyone else. That could change if we find new and/or unexpected benefits from low-dose aspirin.

[sdenton4]

Also addressed in TFA, it turns out. GI symptoms are pretty mild in the universe of cancer drug side effects, and the aspirin slows metastatic cancer spread considerably, so seems like a no brainer.

[Taniwha]

Only for some people, I've taken low dose aspirin (family history of heart attack) for 20 years now without any side effects (except perhaps not dying from heart attacks)

[downWidOutaFite]

I'm annoyed that the FDA has kept cox-2 selective inhibitors restricted when the data I've seen shows they have lower GI risks and similar cardiovascular risks as other NSAIDs.

[rgrieselhuber]

I've heard it's good to take with milk.

[foota]

But they told me to aim high!

[acangiano]

Silver lining to taking it after my heart attack.

[acheong08]

> The Welsh Aspirin Group in Cardiff University has published a systematic review…

Does this Aspirin group have any connections to producers? Is this an ad?

Im currently in Cardiff University. I wonder if I can just go and ask them about it

[RamblingCTO]

Are we microdosing aspirin now?

/e: on a more serious note, what @codevark was downvoted to oblivion for: I'd be interested in a comparison of the anti-inflammatory aspect of aspirin vs food/diet. Anyone got an idea?

[rhqq2]

Can I still drink alcohol and smoke weed everyday, and then take some baby aspirin to offset the increased probability of an early death?

Doubt it ;)

Cheers old buddies.

[8f2ab37a-ed6c]

Now combine that with extra fiber and you'll practically live forever: https://news.ycombinator.com/item?id=38523805

[justinator]

If you climb 50 steps a day as well, you may become unstoppable: https://news.ycombinator.com/item?id=38425724

[softwaredoug]

And fewer calories…

And time restricted feeding (ie 8/16 intermittent fasting)

https://www.nature.com/articles/s41392-022-01163-z

[ensocode]

thanks, that's funny!

[dhuk_2018]

Tomorrow's news will say it will be a 20% increase in some other desease...

[thrtythreeforty]

Depends on the disease, I might make the trade. Cancer is awful.

[smt88]

Aspirin is anti-inflammatory. A huge number of illnesses are caused or worsened by inflammation. Aspirin is likely to show benefit for a huge variety of conditions.

[dr-data]

Found it already! In today's news:

> Currently, a number of randomised trials which test aspirin and mortality are in progress. These focus upon the common cancers: colon, breast, prostate and one in lung cancer. One of these trials, based upon 3021 selected patients in remission from a HER2-negative breast cancer, has already reported [31]. This trial was ended prematurely because aspirin was associated with a possible increase of about 25% in deaths.