Elwood et al. 2016: How many deaths does aspirin cause? A systematic review and meta- analysis.
One of the main barriers to the prescription of aspirin is concern over bleeding in the gastrointestinal tract. Aspirin can cause upper gastrointestinal (GI) bleeding by interfering with the cells lining the stomach, which makes it easier for injury to occur. In fact, aspirin can increase the risk of GI injury and bleeding by about 60%.
Physicians consider internal bleeding of any sort to be a serious issue. However, some researchers are not certain if the risks of GI bleeding are being properly weighed against the cardiovascular and cancer prevention benefits of aspirin. Some believe that excessive concern about the dangers of GI bleeding is preventing people from receiving the full benefits of aspirin.
Eleven randomized medical trials were reviewed and analyzed where participants were given aspirin and the number of gastrointestinal bleeds and participant deaths were reported. This analysis found that, while there was an increase in the risk of gastrointestinal and cerebral bleeding across all of the trials, the risk of fatal GI bleeding did not increase.
The researchers also saw a decrease in deaths from cardiovascular disease, stroke, and cancer in people taking low-dose aspirin. This reduction in overall deaths, the study concluded, outweighs the risks associated with gastrointestinal bleeding.