Aspirin May Lower Women's Colon Cancer Risk
Benefit must be weighed against GI bleeding, other risks, however, experts say
They did not find a difference with cancer deaths between groups, but Cook said there may not have been enough women to show a comparative difference from a statistical point of view.
Cook found no difference in colorectal polyps between groups. Polyps are removed when they are found on colonoscopy as they can progress to cancer.
The aspirin group had more gastrointestinal bleeding, a known side effect, and more peptic ulcers. While 8.3 percent of the aspirin group had GI bleeding, 7.3 percent of the placebo group did. Peptic ulcers affected 7.3 percent of the aspirin group but only 6.2 percent of the placebo group.
While the study included only women, Cook said the results would probably apply to men, too. Other aspirin studies that looked at the effects of the drug, she said, have included mainly men.
Even with the double benefit of heart and colon protection, Cook said, "You really need to balance risks and benefits."
Dr. Anthony Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City, agreed that patients should be carefully selected for aspirin therapy.
Before a doctor suggests aspirin for the colon protection, Starpoli said, the important question is: "Am I really reducing their risk of colon cancer or am I increasing their risk of GI bleeding?"
The strength of the study, he said, is the large number of women. However, he does not think the findings translate to a global recommendation that everyone over 45 take alternate day aspirin for colon cancer risk reduction. "There may be a subgroup of patients at higher risk who could benefit."
Those with a family history of colon cancer or who have had polyps have a higher than average risk.
The side effect of GI bleeding needs to be taken seriously, Starpoli said. "The nature of GI bleeding from nonsteroidal anti-inflammatories [NSAIDs] or aspirin is somewhat unpredictable," he said. And it can be serious and even fatal.
For those hoping to take an aspirin for the double benefit of heart and colon health, would alternate day protect their heart enough?