NEW ORLEANS - Almost 60 percent of the estimated 33 million American adults who regularly use aspirin, ibuprofen and like painkillers are at moderate to high risk of developing serious stomach complications such as bleeding ulcers, a new survey shows. Yet nearly three in four of these people are unaware or unconcerned of the risks, according to the poll of almost 5,000 men and women.

Gastrointestintal complications caused by the painkillers lead to approximately 76,000 hospitalizations and 7,600 deaths annually - a death rate comparable to that of asthma, cervical cancer or skin cancer, reported Dr. Jay Goldstein, an associate professor of medicine at the University of Illinois at Chicago.

Complicating the issue, Goldstein said, is that only one in five people who suffer painkiller-induced stomach complications experiences any prior warning signs. "More than 50 percent of those surveyed thought they would have symptoms such as pain," he said. "Instead, a bleeding ulcer may be the first sign something is wrong."

The national survey is the first to scientifically estimate the risk levels of NSAID users.

Goldstein stressed that he is not suggesting that people stop using aspirin. Rather, he said, be aware of the risks.

"Use of NSAIDs, especially in patients with predisposing risk factors, is a delicate balance of risks versus benefits," said Goldstein, who presented the findings Tuesday at the annual Digestive Disease Week meeting. "We want to make sure that people who benefit from these drugs continue to use them, with the understanding of the issue of risk."

Those at greatest risk for NSAID-induced stomach ills are the elderly, those who are also taking prednisone or other steroids and people who have previously had an ulcer or stomach bleeding, said Dr. Mel Wilcox of the University of Alabama at Birmingham.

QUIZ HELPS DETERMINE RISK

Even people who take a baby aspirin a day to ward off heart disease or stroke may develop a drug-induced bleeding ulcer if they are in a high-risk category, he said.

To help clear up myths about the potentially dangerous side effects associated with NSAIDs, the American Gastroenterological Association has kicked off an education campaign. The cornerstone of the campaign is a risk quiz, Wilcox said.

Regardless of risk, people should not self-medicate with a variety of painkillers, the experts said. With so many painkillers now available without a prescription, many patients have a tendency "to pop a few of these, then pop a few of that - only thinking about stopping their pain, not about what they might be doing to their stomach," Goldstein said.

He related the story of a well-educated lawyer with chronic arthritis who had been prescribed steroids for his condition. The man fell, hurt his back and added over-the-counter NSAID to his pain regimen. The first sign of a problem, Goldstein said, was when he developed anemia and a bleeding ulcer. Four days of hospitalization and blood transfusions were needed to get him back on his feet.

If you are taking painkillers, tell your doctor, Wilcox advised. He may prescribe a drug known as a proton pump inhibitor to protect your stomach.

In addition, new NSAIDs with a lower risk of gastrointestinal ills are on the horizon, he said.

For the Roper survey, 4,799 adults were interviewed by telephone; 807 were identified as having used prescription or over-the-counter NSAIDs such as aspirin, ibuprofen or naproxen to relieve pain and swelling two or more times, for at least five consecutive days, in the previous year.

Among the findings:

People older than 60 are more than twice as likely to underestimate their risk than to provide an accurate assessment. Yet seniors are the most vulnerable to developing digestive tract complications.

Up to 46 percent of adults mistakenly believe that non-prescription NSAIDs are safer with regard to inducing ulcers than those sold only be prescription.