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Health & Medicine for Senior Citizens

More Older Men Should Be Considered for Daily Aspirin to Prevent Cancer Death

Primary benefit of aspiring for middle-aged men increases when this cancer benefit is added to consideration

June 6, 2013 The question of should we take aspirin as a preventive measure never seems to reach a final conclusion. The latest is a research finding that tips the scale in favor a daily aspirin for middle-aged men because of its capacity for preventing cancer deaths, which offsets the risks and thus lowers the age and increase the number of men for whom aspirin should be recommended.

While aspirin has been shown to be effective in preventing heart attacks in men, it also increases the risk of gastrointestinal bleeding and possibly stroke, even at low doses, the researchers write. As such, national guidelines suggest that aspirin be used for prevention only in men at higher risk for cardiovascular events, so that the benefits of aspirin are greater than its adverse effects.

 

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Recent data suggest that aspirin may also be effective for reducing cancer deaths. Would the possible combined health benefits of reducing heart attacks and cancer outweigh the risks of gastrointestinal bleeding and stroke for middle-aged men?

More older men and older women are encouraged to take preventive aspirin by the U.S. Preventive Services Task Force, primarily due to preventive value for heart problems and strokes - see recommendations below.

U.S. Preventive Services Task Force Recommendation

Aspirin for the Prevention of Cardiovascular Disease

  The USPSTF recommends the use of aspirin for men age 45 to 79 years when the potential benefit due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
Grade: A recommendation.

  The USPSTF recommends the use of aspirin for women age 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage.
Grade: A recommendation.

  The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of aspirin for cardiovascular disease prevention in men and women 80 years or older.
Grade: I statement.

  The USPSTF recommends against the use of aspirin for stroke prevention in women younger than 55 years and for myocardial infarction prevention in men younger than 45 years.
Grade: D recommendation.

More Information

A research team, including University of North Carolina scientists, reports that including the positive effect of aspirin on cancer mortality influences the threshold for prescribing aspirin for primary prevention in men. Their results were published in the June issue of the Journal of General Internal Medicine.

Michael Pignone, MD, MPH, study lead author, says, "We found that including a risk reduction for cancer deaths had a substantial impact on the overall benefits of aspirin, especially for early middle-aged men from 45 to 55 years of age. Based on this effect, several million men who were not previously good candidates for aspirin prevention would now become eligible."

Dr. Pignone is professor of medicine and chief of the division of general internal medicine, and a member of UNC Lineberger Comprehensive Cancer Center.

The U.S. Preventive Services Task Force, of which Dr. Pignone is a recently appointed member, recommends aspirin for primary prevention in men "when the potential benefit of a reduction in myocardial infarctions outweighs the potential harm of an increase in gastrointestinal hemorrhage."

This recommendation was issued in 2009, before the potential benefits for cancer reduction were recognized.

Other authors are: Stephanie Earnshaw, PhD, and Cheryl McDade, Research Triangle Institute Health Solutions in Research Triangle Park, NC; and Mark Pletcher, MD, of the University of California, San Francisco.

Funding for the study was provided by Partnership for Prevention and the National Heart, Lung and Blood Institute (R21HL1122256-01) and the National Cancer Institute (K05CA 129166).

University of North Carolina Health Care

 

 

 

 

 

 

 

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