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Comment by MarkMc | Hacker News Reader

It's strange that this article mentions the increased risk of internal bleeding but doesn't mention the reduced risk of cancer.

Here's a study which suggests that if 1,000 people aged 60 took aspirin daily for 10 years then 3 more people would die from strokes, bleeding and ulcers, but 17 fewer people would die from cancer and heart attacks. If that's true, then the benefits of daily aspirin clearly outweighs the costs.

https://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-...

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Aspirin may increase rates of some cancers.

https://discover.dc.nihr.ac.uk/content/signal-000696/aspirin...

> In the ASPREE trial, older adults with no apparent cardiovascular disease who took daily aspirin saw no benefit in terms of reducing the chance of dying or having dementia or disability. Instead, it slightly increased their mortality and bleeding risk - aspirin was associated with an excess of 1.6 deaths per 1,000 people per year. Half of these deaths were due to cancer.

(Although this is at odds with other research and so we need to be careful when interpreting it).

Interesting, but you highlight the major reproducibility crisis of many scientific studies (along with others that have resulted from unfettered money and politics contaminating modern research).

https://www.youtube.com/watch?v=LfHEuWaPh9Q

maybe this brings up a general question. If the effects of aspirin are so complex and interact with so many different forms of complications and benefits, is it even sensible to make a recommendation based on individual factors?

Is maybe some other methodology preferable, like aggregating all the negatives and positives and just make a sort of statistical recommendation?

I can't help but wonder if the risk of bleeding may be due to poor compliance w instructions (it's important to eat before taking asprin)

Aspirin generally and strongly reduces clotting. Bleeds are certainly not solely due to poor compliance -- any minor internal bleed is likely to become much more severe to a patient taking aspirin.

> but 17 fewer people would die from cancer and heart attacks

The other thing to consider is that if '17 people die' there are probably a far larger number of people who don't die but get treated (for cancer) and live but have to deal with the experience of being diagnosed and treated for cancer. It would be interesting to know what that number actually is.

I hope I can be forgiven to not read every single study the article references... But isn't there tremendous Economic incentive to prove asprin is dangerous?

But there are lots of people who's job depends on high asprin sales.

I am concerned this phenomenon creeps over into these studies.

I'm not 100% sure what you're saying, but aspirin is probably the cheapest drug in the world. Nobody is making huge profits from aspirin.

Source?

It's one of the most common medications. At scale I imagine even small margins create profit.

I doubt it. It's a generic that anyone can manufacture and that invariably will squeeze profit margins to almost nothing. In the UK, many supermarkets sell their own brand aspirin and paracetamol for pennies, as loss leaders.

Generic Equate brand Asprin is $3.64 for a 500 count bottle at Walmart. 3/4 of a penny per Asprin. Nobody is printing consequential profit on that.

And that's the cost in what is by far the world's most expensive healthcare environment. The other comment is correct, the competitive market for generic Asprin generally makes it a very low profit product category. The only way to make a bit of money in Asprin, is eg what Bayer does, sell things like orange flavored chewables in their low-dose subset (which is then immediately undercut by generics anyway; Bayer's 300 count version is $10 at Walgreens, the generic version is $6; two to three pennies per).

Surely the incentive of this supposedly big asprin industry would be to prove asprin is safe?

I assume the commenter was talking about other drug companies, e.g. those making drugs for heart disease.

> "If that's true, then the benefits of daily aspirin clearly outweighs the costs."

Why add aspirin though? If you want to reduce the chance of cancer, eat less junk and more vegetables, legumes, and fruits.

Compliance is easier with aspirin than with eating well.

Personal development isn't easy, but there is no pill that can replace a healthy lifestyle.

I took the plunge into a strict, healthy diet 3 years ago and it eventually became easy.

Am I missing the reason these choices are mutually exclusive?

Aspirin may be more effective if you eat badly.

I'm not saying it is.

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