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How a misprint about aspirin might be endangering your life

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  • How can a mis-spelt word put the worlds healthy at risk
  • The way forward... according to Ray

Dear

It seems to be a common belief that we should all be taking a low dose aspirin pill every day.

Certainly most GP's are quick to write a prescription for everything to heart problems, back pain and headaches.

But the media seem to be absolutely convinced that aspirin cures all ills.

'Treat bowel cancer with this every day medicine'... 'The aspirin miracle cure for cancer' and 'Taking aspirin may cut the risk of bowel cancer by a quarter' were just a few of the headlines which screamed at me from the daily papers.

I'm sure that you have seen similar reports in your daily reads, more so if you tend to favour titles such as the Daily Express who have a writer who grabs onto any opportunity to promote this common medication.

Hold on just a minute though, surely there needs to be a bit of balance here.

If you search back through the archives of these newspapers you will find other articles which make equally strong claims why we SHOULDN'T take aspirin unnecessarily as it increased our risk of internal bleeding.

Here we have one of the most widely used drugs in the world being either hailed as a hero or a villan... how can that be?

Let me explain the back stories on all this.

The Jekyll & Hyde drug story

Aspirin was discovered by Felix Hoffman in 1897 and became one of the first drugs come into common usage. It was prescribed for ailments ranging from headaches to arthritis and heart problems.

About 35 million tonnes of this drug is produced and consumed annually around the world, and that's a lot of headaches cured!

Initially, no-one was sure how it worked. But, it seemed effective with little or no side effects so it became prevalent in pain relief management. In fact it wasn't until the 1970's that we discovered that the active ingredient in aspirin, salycilic acid, blocks prostaglandin production and therefore mediates pain.

This discovery actually earned Sir John Vane a Nobel prize for medicine – a huge endorsement to the power of aspirin.

Over the years, aspirin has been used to treat a variety of conditions including heart problems, kidney diseases and even blindness for diabetes sufferers.

Then in 2003 a paper was published in the Lancet by a team from Oxford University which concluded that 'giving daily aspirin to healthy patients whose risk was smaller than heart attack patients would be appropriate'.

QED, as they say in scientific circles – a bunch of scientists say it's a good thing to give aspirin to everyone, and it will help ward off all sorts of evils.

The big problem was that this article was WRONG! There was nothing at fault with the science, or the methodology of the research... even the statistics was correct and accurate.

The problem came down to a simple spelling mistake.

You know the bit in the quote that said it was 'appropriate' to give healthy people aspirin, well it turns out that they meant to say it was 'INAPPROPRIATE'.

By now the damage had been done, and despite retractions and errata sheets, the nations GP's were off and running – aspirin for all.

By March 2010, another team of researchers from Oxford had published their trials which showed that healthy people shouldn't take aspirin for their heart, because the risk of internal bleeding is too great.

There's a great line in their paper which states that if 250 healthy people took aspirin only one would avoid having a heart attack, BUT one person would suffer serious internal bleeding.

I don't like those odds to be honest!

These effects on the gut are as a result of an increase in ulcers and damage to the stomach lining, which calls into question the latest batch of stories about the beneficial effects on bowel cancer.

Here's my take on the story.

The Collins viewpoint...

Yet another Oxford University Professor has been running a trial to establish what effect aspirin has on bowel cancer incident and death rates.

Prof. Peter Rothwell concludes that in his study those taking aspirin were 24% less likely to develop bowel cancer, and if they already had it they were 35% less likely to die from it.

Considering this form of cancer affects upto 16,000 people per year, making it the third most common malignancy, those statistics start to look really impressive.

I can understand why the feature writers might be interested in 4,000 fewer cases per year.

The issue is that it may not work out that way.

A more general view suggests that it is way too early to begin to use aspirin as a blanket preventative for bowel cancer, sure the study states that only 2.5% of those taking aspirin contracted the condition, against 4% of those not taking it – but is this a big enough change to outweigh the risk of bleeding?

Most specialists in the treatment of colorectal disorders don't think so, for instance Professor Dion Morton, a surgeon at University Hospital Birmingham says that unless two of your immediate relatives have developed the problem you shouldn't even think about taking aspirin.

So, it looks like they are going to need more research, let's hope that they do come up with something conclusive that helps GP's and sufferers make the right decisions.

More importantly, I hope that their editor doesn't allow a stupid spelling mistake to misdirect the advice given. (Enough of the editor attacks Ray... I have the power to make you sound really stupid! Ed)

Yours, as always

Ray