HOW TO PREVENT CANCERS

We've dedicated a number of posts over the past year on the policy and health pitfalls of indoor tanning - from the potential benefits of the "tanning tax" (post) to surprisingly high rates of tanning by some youth (post).  Now comes a fascinating, if not perfectly surprising, little analysis on the influence parents can have as indoor tanning enablers.

The small study - reported in the New York Times (story) and printed as a research letter in the Archives of Dermatology (letter - subscription required for full text) - included just over 200 female college students who had at any time in their lives tanned indoors.  Results showed that 40 percent of these students had had their very first tanning experience with their mothers, and that this mother/daughter group of students started tanning at earlier ages and were much more likely to be heavy tanners in college than those who'd first tanned with friends or gone on their own.

For an activity that has well demonstrated health risks, it's surprising that such a high percentage of students were actively introduced to tanning by a parent.  Using an extreme example, it's hard to imagine such a high percentage being introduced to smoking in the same way.

But perhaps the most interesting aspect of the study is how well it demonstrates the dual way that family history may influence future risk of disease.  Genes can certainly play a role but so to can the lifestyle choices that also permeate families - whether it's the food served in the kitchen or the activities done for leisure.  And with over half of all cancer and up to 75 percent of heart disease and diabetes preventable with things we can all do, it's important to realize that the choices made by families could have just as much, if not more, influence on health than the genes they carry.

The documented benefits of aspirin go back, literally, thousands of year.  As early as the fifth century B.C., Hippocrates noted that a bitter willow bark extract - which contained chemicals very similar to today's aspirin - was effective at relieving pain.  Since then, aspirin has become the most commonly used medicine in the world, and its benefits have been shown to reach well beyond pain relief to include the prevention of heart attack, stroke, and now cancer.

Studies have shown for a number of years that taking a daily aspirin could lower the risk of developing and dying of colon cancer, with the latest large analysis by Rothwell and colleagues finding a 25 percent drop in the risk of developing the disease, and a 35 percent risk of dying from it, with as little as 75mg of aspirin a day (previous post; study).

Now, a new analysis by Rothwell and colleagues - which combined data on over 25,000 participants in eight randomized controlled trials - shows big reductions in the risk of cancer deaths with aspirin use, not only for colon cancer, but for a broad range of individual cancers, and for cancer overall (study).   Daily aspirin use for five or more years lowered the risk of cancer death overall by 34 percent compared to placebo.

Strikingly, the benefits persisted, and even expanded, long after the end of the trials and the aspirin treatment.  After up to 20 years of follow-up, overall cancer deaths were 22 percent lower in the aspirin group compared to placebo.  The risk of esophageal cancer death was 58 percent lower.  The risk of colorectal cancer death was 40 percent lower, and lung cancer deaths nearly 30 percent lower.

In general, the longer the daily aspirin use, the more robust the cancer benefits.

The findings of this latest study, combined with all the previous ones, could possibly rebalance the discussion of the risks and benefits of aspirin use.  When looking at aspirin's benefits in the past, the focus was largely on the heart benefits, and while these benefits could be substantial, they still needed to be balanced with the risks that go along with aspirin use, most commonly an increased risk of bleeding in the GI tract and possibly the brain.

With long term demonstrated benefits in lowering cancer deaths, which persist even after daily aspirin use of 5 - 10 years, the balance may be tipping toward the benefits of aspirin outweighing the risks for a broader swath of the population than is currently recommended (which is largely limited to those at high risk of heart attack).

At the cost of just pennies a day, it may just be what the doctor ordered.

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