Doubt on cancer prevention with ASA

Experts express doubts about cancer prevention with ASA: The medical community is skeptical about the alleged cancer prevention with the aspirin Aspirin active ingredient acetylsalicylic acid (ASA).

10/12/2010

The current publication of a study by British researchers in the journal „The Lancet“, in which the aspirin active ingredient acetylsalicylic acid (ASA) has been given a cancer-preventing effect has caused a worldwide stir among medical professionals. But after the initial euphoria, skepticism is growing. Many experts comment and point to serious shortcomings of the published study.

The British researchers led by the neurologist Peter Rothwell from the University of Oxford had evaluated eight studies with over 25,000 participants and came to the conclusion that a regular low dose of aspirin, the risk for many cancers significantly reduced. Depending on the tumor type, the cancer risk was reduced by 20 to 35 percent from the daily intake of at least 75 milligrams of aspirin, by as much as 60 percent in esophageal cancer and by 40 percent in colorectal cancer, the researchers reported „The Lancet“-Items. The international interest of the medical community was great in view of the surprising result and it was already first thought games for the preventive use of ASA against cancer employed. But now doubts about the credibility of the study results grow, because numerous experts attest to the study's significant shortcomings.

For example, the team led by neuroscientist Peter Rothwell said his statement that ASA reduced the risk of lung and prostate cancer by 20 percent in 20 years to just four years, said Raymond DuBois of the Anderson Cancer Center the University of Texas. It was also not checked whether the intended participants took at least 75 milligrams of the aspirin drug daily or whether the other participants in the control group, which should receive only sham drugs, actually completely waived aspirin, so another charge of the expert. In addition, all eight studies were originally designed to examine the effects of ASA intake on cardiac risk, not cancer risk, DuBois explained. Thus, factors that speak for an increased risk of cancer, such as a family history, were not recorded in the participants. Therefore, the present study is in the opinion of Raymond DuBois not suitable to draw long-term conclusions on the tumor risk. „On the basis of this study, one certainly should not make a therapeutic decision“, emphasized DuBois.

It was also noticeable in the opinion of the critics that in the British study among the women, who made up about a third of the participants, the reduction of the risk of cancer could not be determined by taking ASA. Already earlier studies of the American Cancer Society had come to a similar conclusion, according to which it can be assumed that aspirin in most cancers has no protective effect - lung cancer is the exception here. Even the older studies with more than 40,000 American women had a slight reduction in lung cancer risk, said the critics of the current „The Lancet“-Article.

Epidemiologist Eric Jacobs of the American Cancer Society was a bit more reserved with his critique of the current findings than his colleague from the Anderson Cancer Center and said the results were quite plausible. However, Jacobs pointed out that a US commission of experts explicitly discourages people with normal cancer risk from taking ASA for prevention, as it may, for example, interfere with blood clotting and cause gastrointestinal bleeding.

The cancer expert Ed Yong of the organization Cancer Research UK also expressed doubts in view of the preventive use of ASA: „Balancing the pros and cons of aspirin is very important and should be done on an individual basis“, Yong stressed, adding: „Anyone who considers taking aspirin on a regular basis should first talk to their doctor“. A preventive ASA intake, most medical professionals, not least because of possible side effects, in any case extremely critical. In addition, the current study by British researchers also appears to have doubts for another reason. Because six of the seven authors of „The Lancet“-The products have a good track record in the pharmaceutical industry and have been on the payroll of pharmaceutical companies producing the aspirin drug ASA and similar medicines in the past. A connection in the light of the current article, quite critical to evaluate. (Fp)

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Picture: Jens Goetzke