should everyone over 50 take a baby aspirin once a day? if you have been watching the news carefully, you might think so. the u.s. preventative services task force just put out a draft statement recommending a baby aspirin once a day to cut the risk of colon cancer. quite apart from its cardiovascular benefit, the usptf is suggesting that aspirin can prevent cancer in those between the ages of 50 and 70.
first, it’s important to note that the evidence supporting the use of aspirin to prevent colon cancer is quite substantial. a 2012 meta-analysis of the data suggests that there is good quality evidence that daily aspirin therapy reduces the risk of colon cancer. but not all the evidence is positive and two large trials, not included in the analysis, showed no benefit. in both, the physician’s health study and the woman’s health initiative, aspirin did not prevent colon cancer.
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the big change here is that in the intervening 20 years new medications to control blood pressure and cholesterol have gone a long way toward reducing cardiovascular risk. a 2012 meta-analysis of the old and new data found that aspirin had a small benefit in preventing non-fatal heart attacks but that the benefit was cancelled out by an increased risk of bleeding.