Every day it seems there’s a new headline asking whether a low-dose aspirin can ward off colorectal cancer or help patients beat it. Doctors know aspirin thins the blood and eases inflammation, and decades of research hinted it might also slow polyp growth or cancer spread.
But the truth is not as simple as a yes or a no. Recent studies paint a mixed picture – with potential benefits for some people and real risks for others. As major health bodies have revised their advice, readers are left wondering: should I take aspirin for colon or rectal cancer?
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Who might benefit?
Not everyone gains the same advantage from aspirin. New research suggests the biggest payoff is for those at higher risk. In one large US cohort study, people who led “unhealthy” lifestyles- marked by obesity, smoking, poor diet or heavy drinking, saw a sharper drop in colorectal cancer risk if they took aspirin regularly. For example, those with multiple risk factors had about a 3.4% ten-year risk of cancer without aspirin versus 2.1% with it.
By contrast, very healthy people barely gained much – their 1.5% risk fell only to 1.6% (essentially unchanged). In practical terms, treating 78 high-risk patients with aspirin might prevent one cancer over ten years, but you’d need 909 healthy people on aspirin to spare one case.
Experts say aspirin could “proportionally lower the markedly elevated risk” in those with many risk factors.
Large population studies back this up. A recent Norwegian registry study of over two million people age 50–79 found that regular low-dose aspirin users had about 13% lower colorectal cancer incidence than non-users.
Large population studies back this up. A recent Norwegian registry study of over two million people age 50–79 found that regular low-dose aspirin users had about 13% lower colorectal cancer incidence than non-users.
There’s also a genetic angle. People with Lynch syndrome (a hereditary colon-cancer syndrome) have extremely high lifetime risk, and trials now show even a baby aspirin daily sharply cuts their chances of bowel cancer. Britain’s NICE guidelines already recommend that anyone with Lynch syndrome “consider taking aspirin daily to prevent bowel cancer”.
Who should steer clear
The flip side is that aspirin isn’t harmless. Even at low doses, it can irritate the stomach lining and raise the risk of serious bleeding or stroke. Medical guidelines now emphasize caution. In 2022 the US Preventive Services Task Force removed colorectal cancer from its aspirin guidelines, saying the latest evidence of benefit wasn’t clear and noting the “harms of taking aspirin” like ulcers.
In fact, doctors warn that anyone with a history of stomach ulcers, bleeding disorders, or those on blood thinners should generally avoid routine aspirin. Older adults and people with uncontrolled high blood pressure face higher bleeding risk if they pop aspirin daily.
Even aside from bleeding, some high-quality trials in broad patient groups have been underwhelming. For example, a recent international trial found that adding aspirin 200 mg daily after standard colon or rectal cancer treatment did not significantly improve disease-free survival.
But the truth is not as simple as a yes or a no. Recent studies paint a mixed picture – with potential benefits for some people and real risks for others. As major health bodies have revised their advice, readers are left wondering: should I take aspirin for colon or rectal cancer?
Video
Who might benefit?
Not everyone gains the same advantage from aspirin. New research suggests the biggest payoff is for those at higher risk. In one large US cohort study, people who led “unhealthy” lifestyles- marked by obesity, smoking, poor diet or heavy drinking, saw a sharper drop in colorectal cancer risk if they took aspirin regularly. For example, those with multiple risk factors had about a 3.4% ten-year risk of cancer without aspirin versus 2.1% with it.
By contrast, very healthy people barely gained much – their 1.5% risk fell only to 1.6% (essentially unchanged). In practical terms, treating 78 high-risk patients with aspirin might prevent one cancer over ten years, but you’d need 909 healthy people on aspirin to spare one case.
Experts say aspirin could “proportionally lower the markedly elevated risk” in those with many risk factors.
Large population studies back this up. A recent Norwegian registry study of over two million people age 50–79 found that regular low-dose aspirin users had about 13% lower colorectal cancer incidence than non-users.
Large population studies back this up. A recent Norwegian registry study of over two million people age 50–79 found that regular low-dose aspirin users had about 13% lower colorectal cancer incidence than non-users.
There’s also a genetic angle. People with Lynch syndrome (a hereditary colon-cancer syndrome) have extremely high lifetime risk, and trials now show even a baby aspirin daily sharply cuts their chances of bowel cancer. Britain’s NICE guidelines already recommend that anyone with Lynch syndrome “consider taking aspirin daily to prevent bowel cancer”.
Who should steer clear
The flip side is that aspirin isn’t harmless. Even at low doses, it can irritate the stomach lining and raise the risk of serious bleeding or stroke. Medical guidelines now emphasize caution. In 2022 the US Preventive Services Task Force removed colorectal cancer from its aspirin guidelines, saying the latest evidence of benefit wasn’t clear and noting the “harms of taking aspirin” like ulcers.
In fact, doctors warn that anyone with a history of stomach ulcers, bleeding disorders, or those on blood thinners should generally avoid routine aspirin. Older adults and people with uncontrolled high blood pressure face higher bleeding risk if they pop aspirin daily.
Even aside from bleeding, some high-quality trials in broad patient groups have been underwhelming. For example, a recent international trial found that adding aspirin 200 mg daily after standard colon or rectal cancer treatment did not significantly improve disease-free survival.
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