Study shows lower dose aspirin works as expert warns ‘too many people are missing out on a potentially life-changing opportunity to prevent cancer’
An aspirin a day can prevent bowel cancer in people at high risk of the disease, research has confirmed.
A new trial of 1,900 participants suggests GPs can recommend a low dose aspirin for people with the genetic condition Lynch syndrome. Higher doses of aspirin have previously been shown to prevent bowel cancer in this group but experts say GPs are still not advising it for these patients, partly due to concerns about the dosage.
Lead author Professor Sir John Burn, of Newcastle University, said: “Only a quarter of people with Lynch syndrome are currently taking aspirin. Too many people are missing out on a potentially life-changing opportunity to prevent cancer.”
“For 30 years, scientists have observed fewer cancers in people who take aspirin. This trial now tells us that aspirin can prevent bowel cancer at lower doses, minimising the chances of side-effects whilst offering vital protection for people with Lynch syndrome.”
Lynch syndrome is a rare genetic condition that runs in families and one in 400 people in England have it – equivalent to around 175,000 people. Having Lynch syndrome substantially increases the risk of bowel cancer and increases the risk of other types of cancer, including womb, ovarian and prostate cancer.
The CaPP3 trial involved 1,879 people with Lynch syndrome in the UK, three other European countries and Australia who were treated with aspirin over five years. Participants on the trial were given three different doses of aspirin – 75-100mg, 300mg or 600mg a day – and received regular checks to see how they were doing throughout.
Case Study
Nick James, 46, a furniture maker from Gosforth in Newcastle, was the first to sign up to the CaPP3 trial in 2014. Nick decided to undergo genetic testing after his mum died from cancer, and other family members were diagnosed with bowel cancer. Tests showed he is a carrier for a faulty gene which causes Lynch syndrome.
Nick now has a colonoscopy every two years, continues to take aspirin, and remains cancer free. He said: “Finding out I had a faulty gene that causes Lynch syndrome was extremely daunting, but taking part in this trial has given me hope that there is something that can reduce the chances of me and others developing cancer.
“It was fascinating to hear about how something as small as aspirin could potentially make such a big difference to my future. Taking three aspirin tablets a day wasn’t hard, but it has helped this study and it could potentially help lots of people in the future.”
The trial found that those on the lowest aspirin dose did just as well as those on the higher doses, with fewer bowel cancers across all three doses. Aspirin given at lower doses is likely to cause fewer side-effects, including bleeding and stomach ulcers, than at higher doses.
Scientists leading the research are now in talks with the British National Formulary, used by all pharmacists and doctors, to update the advice it gives on aspirin.
Professor Burn added: “We’re now engaging with the regulators to change prescribing guidelines so that aspirin can be used more widely for people with a high risk of bowel cancer. We have a chance to give more people with Lynch syndrome protection which would reduce their fear of bowel cancer in the future.”
The National Institute of Health and Care Excellence (NICE) currently recommends that people with Lynch syndrome consider taking aspirin daily to prevent bowel cancer. But a survey carried out in 2016 revealed 47% of GPs were aware that they should recommend aspirin to people with Lynch syndrome and many were worried about the higher dose.