Should You Take Low-Dose Aspirin to Lower Pancreatic Cancer Risk?

For certain patients, it may be worth considering
bottle of aspirin

There’s been a lot of buzz about taking aspirin to reduce your risk for pancreatic cancer, but these links are still a long way from being proven, says R. Matthew Walsh, MD, Chair of General Surgery, Cleveland Clinic.

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The overall body of literature doesn’t support the use of aspirin to lower their pancreatic cancer risk for most people. This is because regular use of aspirin can have serious side effects, such as internal bleeding. However, even though aspirin isn’t actually proven to work, he might suggest it for certain patients with a strong family history of pancreatic cancer.

 “You have to take it for a long time. The longer people are on aspirin, the better their success rate,” he says. “I can’t say the data is very strong. But, at a low dose, the side effects are minimal, so it’s worth considering.”

What research says

The research on using low-dose aspirin to reduce pancreatic cancer risk hasn’t offered conclusive results. The overall body of literature on the topic is very mixed.

“Occasional studies show reduced risks of pancreatic cancer, but most show no connection either way,” Dr. Walsh says. “There are quite a few trials on this topic and the results are mixed.”

For example, the Yale School of Public Health released a study in June linking aspirin use to a reduced risk. However, a closer look at the study reveals that the sample was relatively small, Dr. Walsh says.

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“It drew from patients in a separate trial using aspirin as a guard against heart disease, and then researchers said, ‘Let’s look at this secondary endpoint.'”

This means that the sample was compared against a control group of patients who may or may not have received aspirin. Through that comparison, “They came up with a risk reduction from people on a low dose of aspirin,” Dr. Walsh says.

Smoking, family history greater risks

The literature shows much stronger risks of pancreatic cancer among those who smoke, first and foremost, and among those with a family history of pancreatic cancer, Dr. Walsh says.

“The best thing you can do to reduce your risk of pancreatic cancer is to stop smoking,” he says.

Some linkage also pops up among patients with pancreatitis, perhaps due to inflammation that puts the pancreas more at risk.

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Why could aspirin help reduce risk?

The theory that aspirin can help is based on its work as an anti-inflammatory drug. The thought is that it could, as such, alter the pro-inflammatory mediators in our pancreatic tissue. “If we can block inflammatory mediators we could change the cancer rate,” Dr. Walsh says.

However, he says this is really hard to prove. “The take-home, as a concept, is that it’s a little too preliminary to recommend it for most people.”

He advises people who are concerned about pancreatic cancer risk to talk to their doctor. It’s important to weigh the potential benefits of taking low-dose aspirin with the risks, while taking into account each person’s medical history.

Those with a high risk due to their family history may want to talk to their doctor about visiting a genetics counselor or undergoing surveillance imaging to watch for any suspicious growths in the pancreas.

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