Aspirin reduces all cause mortality and cancer risk in elderly: JAMA

USA: Long-term use of aspirin has been linked to reduced cancer risk and mortality, particularly colorectum cancer. Now, a recent study published in the JAMA Network Open has found that aspirin use 3 or more times in a week reduces all-cause, any cancer, gastrointestinal (GI) cancer and colorectal (CRC) mortality in older adults.

Although aspirin use has been associated with reduced risk of cancer mortality, particularly of the colorectum, its efficacy may be influenced by biological characteristics, such as obesity and age. With the increasing prevalence of obesity and conflicting data regarding aspirin effect in older adults, it becomes imperative to understand the potential association of aspirin use with cancer mortality according to body mass index (BMI).

Holli A. Loomans-Kropp, National Cancer Institute, Rockville, Maryland, and colleagues conducted the study to investigate the association of aspirin use with risk of all-cause, any cancer, GI cancer, and CRC mortality among older adults and to perform an exploratory analysis of the association of aspirin use with mortality stratified by BMI.

The study involved 146,152 individuals (mean age at baseline, 66.3 years) who were followed for a median of 12.5 years encompassing 1,822,164 person-years.

Read Also: Low-dose aspirin for long duration lowers lung cancer risk: JAMA

Key findings of the study include:

• Compared with no use, aspirin use 1 to 3 times per month was associated with a reduced risk of all-cause mortality (HR, 0.84) and cancer mortality (HR, 0.87).


• Aspirin use 3 or more times per week was associated with decreased risk of mortality of all causes (HR, 0.81), any cancer (HR, 0.85), GI cancer (HR, 0.75), and CRC (HR, 0.71).


• When stratified by BMI (calculated as weight in kilograms divided by height in meters squared), aspirin use 3 or more times per week among individuals with BMI 20 to 24.9 was associated with reduced risk of all-cause mortality (HR, 0.82) and any cancer mortality (HR, 0.86).


• Among individuals with BMI 25 to 29.9, aspirin use 3 or more times per week was associated with reduced risk of all-cause mortality (HR, 0.82), any cancer mortality (HR, 0.86), GI cancer mortality (HR, 0.72), and CRC mortality (HR, 0.66).

"Although this study had several limitations, the research questions investigated examining the associations among aspirin use, BMI, and mortality adds to our knowledge of modifiable factors associated with cancer prevention efficacy. We were able to explore this question in a large, prospective study with an extended follow-up period," wrote the authors.