The article describes a recent observational study which suggests aspirin may be associated with lower risk for urinary symptoms of an enlarged prostate, or benign prostatic hyperplasia (BPH). The article describes the evidence–namely that it was based on an observational study and not a randomized controlled trial–but limitations of observational studies were not described to readers (e.g. the effects observed may have been caused by other factors). Other areas for improvement include: reporting benefits in absolute terms (absolutely better than using relative terms); the nature of BPH is not described, particularly that this is not a cancerous or life-threatening condition; other treatment alternatives are not described; the only source of information is from the lead investigator, which could be biasing; and there is no information on harms or costs of daily aspirin use for this purpose. Although this was clearly intended as a “brief,” the discussion of this study was just too brief to help readers understand the evidence.
The article does not mention any costs of these medications if taken on a daily basis or per dose.
The story describes benefits in relative terms vs. absolute rates (which is the gold standard). It also does not tell readers that the most benefit was seen in older men.
The article does not mention any harms of using daily aspirin (like bleeding).
The article acknowledges that the study was observation and not a placebo-controlled trial, but there is no interpretation or discussion about the limitations of this. The article also uses language that minimizes the poor quality of the evidence and hypes the findings (“Still, we were surprised by the strength of the association…).
The article provides very limited information about prostate enlargement, known as benign prostatic hyperplasia or BPH. Of note, this condition is not cancerous or life-threatening. Also, the article mentions a possible benefit being lower PSA levels, noting that this is a common blood test for prostate cancer. This implies that using aspirin or other similar drugs for BPH can also reduce a man’s chance of prostate cancer, for which there is no evidence. In fact, elevated PSA levels can often be due to conditions like BPH and not due to cancer; with less enlargement of the prostate, it’s not unexpected to also find lower PSA levels. The broad use of the term “urological problems” also seems to overstate what the study was about, evaluating a specific condition (BPH).
The article only quotes the lead investigator, which can be biasing. The article did not quote an independent source of information.
The article does not discuss any other treatment options, including watchful waiting (no active treatment), medications like 5-alpha reductase inhibitors or alpha blockers, minimally invasive therapies, and surgery.
The article mentions medications like aspirin, naproxen, and ibuprofen, all of which are currently available (and available without a prescription, although this is not explicitly stated).
The story names the drugs studied–aspirin, naproxen, and ibuprofen–none of which is new to the market. This is a new use of existing medications.
We can’t be sure if the story relied largely on a news release, although it is troubling that only one source – the lead investigator – is quoted.