Doubts about cancer prevention with ASA

Experts express doubts about cancer prevention with ASA: Medical experts are skeptical about the alleged cancer prevention with the ASA aspirin active ingredient acetylsalicylic acid (ASA).

The recent publication of a study by British researchers in the specialist magazine "The Lancet", in which the aspirin active ingredient acetylsalicylic acid (ASA) was found to have a cancer-preventive effect, has caused a sensation among medical professionals worldwide. But after the initial euphoria, skepticism is growing. Numerous experts speak up and point out serious shortcomings in the published study.

The British researchers led by 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 significantly reduced the risk of numerous types of cancer. Depending on the type of tumor, the risk of cancer was reduced by 20 to 35 percent by taking at least 75 milligrams of aspirin daily, by as much as 60 percent in esophageal cancer and by 40 percent in colon cancer, the researchers reported in "The Lancet" article. In view of the surprising result, the international interest of the medical professional community was great and the first thought games about the preventive use of ASA against cancer were started. However, doubts about the credibility of the study results are growing, because numerous experts certify that the study has significant deficiencies.

For example, the team led by neurologist Peter Rothwell based his statement that ASA could reduce the risk of death from lung or prostate cancer by 20 percent in 20 years based on a four-year observation period, explained Raymond DuBois from the Anderson Cancer Center the University of Texas. It was also not checked whether the intended participants ingested at least 75 milligrams of the aspirin active ingredient daily or whether the other participants in the control group, who were only supposed to receive dummy medicines, actually completely did without aspirin, according to the expert. In addition, all eight studies were originally designed to examine the effects of ASA intake on heart risk, not cancer risk, DuBois said. For example, factors that indicate an increased risk of cancer, such as a family history, were not recorded in the participants. According to Raymond DuBois, the present study is therefore not suitable for drawing long-term conclusions about the tumor risk. "On the basis of this study, you should definitely not make a therapy decision," emphasized DuBois.

In the opinion of the critics, it was also striking that in the British study, women who made up around a third of the participants were unable to reduce the risk of cancer by taking ASA. Earlier studies by the American Cancer Society had come to a similar result, according to which it can be assumed that aspirin does not have a protective effect in most types of cancer - lung cancer is the exception here. Because the older studies with over 40,000 American women had also found a slight reduction in the risk of lung cancer, said the critics of the current "The Lancet" article.

The American Cancer Society's epidemiologist Eric Jacobs criticized the current results a little more cautiously than his colleague from the Anderson Cancer Center and declared the results to be quite plausible. Jacobs pointed out, however, that a US expert commission explicitly advised people with normal cancer risk against taking preventive ASA, for example, because the agent impaired blood clotting and could cause bleeding in the digestive tract.

Cancer expert Ed Yong of Cancer Research UK also expressed doubts about the preventive use of ASA: "It is very important to weigh the advantages and disadvantages of aspirin against one another, and this should be done on an individual basis," emphasized Yong, adding: If you are considering taking aspirin regularly, you should speak to your doctor first. ” Most physicians see preventive ASA intake as extremely critical, not least because of the possible side effects. In addition, the current study by British researchers also appears to have doubts for another reason. Because six of the seven authors of the "The Lancet" article have good ties to the pharmaceutical industry and were in the past on the payroll of pharmaceutical companies that produce the aspirin active ingredient ASS and similar drugs. A connection which, in view of the current article, should be critically evaluated. (fp)

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Painkillers as the cause of pain?
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Image: Jens Goetzke /

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