The media were full of the story last week that a stunning new study showed that if you took aspirin regularly you would reduce your chances of getting melanoma. The actual paper was published online ahead of print in CANCER and can be obtained from Dr. Stark by requesting on the form to the right of this posting (he can’t post the article itself because of copyright restrictions). You can see an abstract of the article here. The Women’s Health Initiative, most famous for convincing millions of women to get off premarin, analyzed retrospectively aspirin use among post-menopausal women and concluded that there was a 22% reduction in melanoma among regular aspirin users. The power of the study is the numbers — nearly 60,000 women. The fatal flaws are numerous, including lack of uniformity in aspirin dose (one dose a week was all it took to get you into the aspirin group) and the failure of women to stay on aspirin for the duration of the study, averaging over ten years. Clearly an enzyme in cellular metabolism, cyclo-oxygenase, has an effect on cancer causation, and clearly aspirin and non-steroidals such as ibuprofen can inhibit this enzyme, but does this study shed any light on this issue? Dr. Stark would contend that its flaws make it uninterpretable. Clearly low-dose daily aspirin prevents heart attacks and (probably) colon cancer, but does it prevent melanoma? The authors of the paper say yes, but Dr. Stark expects the paper to be savaged in the scientific community in coming weeks.