Bladder cancer is one of the most common cancers affecting the urinary system. It begins in the tissues lining the bladder, the organ that stores urine before it leaves the body.
One of the earliest and most important warning signs of bladder cancer is blood in the urine. Sometimes the blood is visible, causing the urine to appear pink, red, or brown. In other cases, the bleeding is so small that it can only be detected through medical tests.
Early detection is important because bladder cancer is often easier to treat when it is found before it spreads into deeper layers of the bladder wall. However, many bladder tumors cause few or no symptoms in their earliest stages. As a result, some people may have bladder cancer without knowing it.
Now, a new study published in the Journal of Internal Medicine suggests that aspirin may indirectly help doctors identify some hidden bladder cancers earlier than they otherwise would.
Aspirin is one of the most widely used medications in the world. Many people take low-dose aspirin to help prevent heart attacks and strokes because the drug reduces the ability of platelets in the blood to form clots. By preventing harmful clots, aspirin can lower cardiovascular risk in certain patients.
However, because aspirin affects blood clotting, it can also make minor bleeding more noticeable. If a person already has a small source of bleeding somewhere in the body, aspirin may increase the likelihood that the bleeding becomes visible.
Researchers wondered whether this effect could help uncover previously undiagnosed bladder cancers. To investigate, scientists from Denmark examined health records from more than 50,000 adults who began taking aspirin between 2005 and 2023.
They also studied more than 156,000 people who started taking non-aspirin non-steroidal anti-inflammatory drugs, commonly known as NSAIDs.
NSAIDs include medications such as ibuprofen and naproxen. Although these drugs can also affect bleeding, they generally have weaker effects on platelet function than aspirin.
The researchers compared both groups with people from the general population who had not used aspirin or NSAIDs. They looked specifically at how often participants underwent cystoscopy, a procedure in which a doctor inserts a thin flexible tube equipped with a camera into the urinary tract to examine the bladder.
The results showed that people who had recently started taking aspirin underwent more cystoscopies than individuals who had never used aspirin. When doctors performed these examinations, they found bladder cancer at similar rates compared with non-users. However, an important difference emerged.
Among aspirin users who were diagnosed with bladder cancer, fewer cases had already progressed to invasive disease. In other words, their cancers tended to be detected at earlier stages.
The researchers believe aspirin may be revealing small amounts of bleeding from tumors that would otherwise remain unnoticed. Once blood appears in the urine, patients are more likely to seek medical attention, leading doctors to perform further testing and discover cancer sooner.
The findings differed for people taking non-aspirin NSAIDs. Although these patients also underwent more cystoscopies, they were less likely to have bladder cancer detected. In addition, the stage of cancer at diagnosis was similar to that seen in people who never used these medications.
According to the researchers, this suggests that the additional cystoscopies among NSAID users may not have been as clinically useful as those performed in aspirin users.
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Source: Aarhus University.
