Express Your Contempt

Right. The Daily Express. You know, that suppositry that thinks it’s a newspaper? Well, today it carries the headline “ASPIRIN STOPS BOWEL CANCER“. Apparently Princess Diana was unavailable for comment.

Whatever about bowel cancer, I can always spot the work of an arsehole.

I suppose it’s an appropriate cancer for them to focus on given that the rectal region seems to be where their content comes from.

As you might be able to tell, I’m a bit pissed off about this. The cancer research institute I work for connects on directly to a cancer hospital, and I spend at least sometime every day over at the hospital. I saw this headline glaring out from the newstand in the hospital shop. And that’s what upsets me. This approach to cancer reporting by the Express and, of course, the Daily Wail, matters.

Let me state this now: aspirin does NOT stop bowel cancer. And to claim otherwise is emotionally exploitative. I don’t doubt that numerous patients and relatives in oncology units across the country have seen this headline. And this sort of reporting really has an impact in the psyche of those affected by cancer.

I lost my dad to lung cancer 2 years ago, around the time that papers like the Express and the Mail were carping on about broccoli curing cancer. It doesn’t. However we did get well-meaning people asking if we and the NHS were forcing my dad to eat broccoli. He was stage IV and had about 1 month at this point. It was genuinely upsetting at the time to have this false “cure” being championed at a time when we knew the reality and just wanted to focus on what lay ahead.

That said, at least this case is a little different. Aspirin, and other non-steroidal anti-inflammatories (NSAIDs) are thought to lower the incidence of bowel cancer. This is not exactly new thinking. This effect has been documented for quite some time, going back to at least 1991. The study that the Express is reporting on is a good study. But in no way does it imply that aspirin STOPS bowel cancer.

What it does say is that they were able to detect a lower incidence of bowel cancer in people taking as little as 75mg per day of aspirin. Yet again the papers are unable to deal with numbers. The Express breathlessly claims that the rates were 25% lower for people taking daily aspirin (which, incidentally, is NOT the same as STOPPING bowel cancer as the headline of the article claims). However this is a relative measure, and it is all down to how you handle stats. To truly be able to claim this you would have to do a long term study, and I’m talking decades-long, following groups of people who took aspirin everyday for their whole life and groups who never touched aspirin. Then you would compare the rate of colorectal cancer (CRC) in the two populations.

The way these figures were calculated was, basically, by comparing the rate of people already disagnosed with CRC who self-reported that they had been taking NSAIDs daily for a long time and the rate of people currently not suffering CRC who self-reported that they had been taking NSAIDs. This is a perfectly acceptable way to conduct a study, and is indeed informative. But you can’t extrapolate from this to stay aspirin stops bowel cancer. All this study does is lend evidence that, in some cases, long-term use of aspirin seems to correlate with a lower rate of CRC.

Interestingly the actual rates of aspirin intake was not particularly different between the control and disease groups. Of the disease cohort, 15.5% were low-dose aspirin users. Of the control cohort that figure rose to 18.1%. So that’s not actually drastically different.

The study also shows that taking aspirin at low dose had no measurable effect on survival of CRC.

I really don’t know quite why they leapt upon this study. It is by no means a conclusive report of “take aspirin -> no bowel cancer for you”. It’s another fairly standard study that indicates an effect. That’s all.

So, should you be taking aspirin to fend of bowel cancer? Well: no, the benefit isn’t shown to be worth it to most people.

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