Aspirin May Reduce Your Risk of Prostate Cancer

What You Need to Know: A recent meta-analysis (study of a group of studies) demonstrated an association between aspirin use and a reduced risk of prostate cancer.

Background: Anti-inflammatory medications lower prostate-specific antigen (PSA) levels; therefore, whether these findings reflect reduced prostate cancer detection or lower risk of the disease is not known.

The Study: Researchers tested the association between aspirin and non-aspirin nonsteroidal anti-inflammatory drug (NSAID) on prostate cancer diagnosis in the REDUCE trial, where all men underwent biopsy at 2- and 4-years largely independent of PSA. The researchers examined the association between aspirin, NSAID, or both and total, low-grade (Gleason <7) prostate cancer, or high-grade (Gleason ≥7) prostate cancer vs. no prostate cancer using multinomial logistic regression among 6,390 men who underwent on-study biopsy one or more times. Overall, 50% of the men were nonusers, 21% used aspirin, 18% used NSAIDs, and 11% of the men used both.

Results: In multivariable analyses, aspirin was associated with reduced total prostate cancer risk, but use of NSAID or NSAIDs and aspirin was not associated with reduced risk of prostate cancer. Therefore, we created a dichotomous variable of aspirin and/or NSAID user vs. not. On multivariable analysis, the use of aspirin and/or NSAID was significantly associated with decreased total and high-grade (dangerous-type) prostate cancer risk, but not with risk in low-grade prostate cancer.

My Take: While I cannot make an across-the-board recommendation for everyone to take aspirin (we do not have high0level evidence to support doing so; in addition, there are potential serious risks associated with the use of NSAIDs and/or aspirin), I envision a future in which decisions will be individualized. We will look at your risk of heart disease, stroke, prostate and colon cancer as well as potential side effects such as stomach bleeding. I’m Dr. Michael Hunter, and I take a baby (81mg) aspirin daily (my dad had a stroke at 85 years-old).

Reference: Clinical Cancer Research, 12/18/2014 Clinical Article

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Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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