Aspirin shown to reduce risk of pancreatic cancer

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BMJ 2002;325:356 ( 17 August )

News

Aspirin shown to reduce risk of pancreatic cancer

Scott Gottlieb, New York

Aspirin, already known to reduce the risk of colon cancer, may also prevent cancer of the pancreas.

In a seven year study of more than 28000 postmenopausal women aged 55 to 69 who were participants in the Iowa women's health study, the risk of pancreatic cancer was 43% lower in women who took aspirin or products containing aspirin than in women who did not (relative risk 0.57 (95% confidence interval 0.36 to 0.90)). The more often that women took aspirin, the lower their risk of the cancer (Journal of the National Cancer Institute 2002;94:1168-71)[Abstract/Full Text].

A decreased incidence of pancreatic cancer with use of non-steroidal anti-inflammatory drugs (NSAIDs) has been shown by other studies, all of which were studies of patients taking NSAIDs for other indications, such as rheumatoid arthritis. This is the first study to directly examine the relation between aspirin use and pancreatic cancer.

The study showed that the protective effects of aspirin increased with frequency of use. Compared with women who never took aspirin, women who took aspirin 2-5 times a week had a 53% lower risk and women who took it >= 6 times a week had a 60% lower risk.

The study's lead author, Dr Kristin Anderson of the University of Minnesota in Minneapolis, said she and her colleagues "tried to make the effects of aspirin go away" by taking into account characteristics of the women that could have influenced the results, such as age, the presence of diabetes, and whether they smoked or took multivitamins. "Nothing made the aspirin effect go away," Dr Anderson said.

While the mechanism by which aspirin could reduce the incidence of pancreatic cancer is not clear, it is thought to involve inhibition of expression of cyclo-oxygenase 2---but it probably involves other mechanisms as well, say the researchers. In the study, other NSAIDs, such as ibuprofen, did not decrease the incidence of pancreatic cancer, perhaps reflecting differences in their mechanism of action, said Dr Anderson.

She cautioned, however, that the researchers did not have enough evidence to rule out that other NSAIDs may reduce the risk of pancreatic cancer. She said that the women in the study were asked in 1992 about their use of NSAIDs, when the drugs were not as widely used and some newer types had not yet been introduced.

The researchers did not collect data on the dose of aspirin the participants took or on the length of time that they were taking aspirin before enrolling in the study. They looked only at current use, which precludes a comparison of short term and long term use. Also, the homogeneity of the study population---postmenopausal women, 98% of whom were white---makes it difficult to generalise the results.

 


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