A study led by researchers at Mass General Brigham, published in JAMA Oncology, suggests that regular aspirin use may help lower the risk of colorectal cancer, especially in people with certain lifestyle-related risk factors.
Colorectal cancer is the second-leading cause of cancer death in the United States. Previous guidelines recommended daily low-dose aspirin for adults aged 50 to 59 to prevent both heart issues and colorectal cancer.
However, in 2016, this recommendation was withdrawn due to concerns about the risk of gastrointestinal bleeding from aspirin.
The research team analyzed health data from 107,655 participants in the Nurses’ Health Study and the Health Professionals Follow-Up Study. They compared colorectal cancer rates between those who regularly took aspirin and those who did not.
Regular aspirin use was defined as taking either two or more standard-dose (325 mg) tablets per week or a daily low-dose (81 mg) aspirin.
Participants were followed from an average starting age of 49.4 years. The study found that those who regularly took aspirin had a lower 10-year cumulative incidence of colorectal cancer (1.98%) compared to those who did not take aspirin (2.95%).
The benefit of aspirin was most significant among individuals with the least healthy lifestyles. For those with the lowest healthy lifestyle scores, the chance of getting colorectal cancer was 3.4% without regular aspirin and 2.12% with regular aspirin.
In contrast, for those with the highest healthy lifestyle scores, the rates were 1.5% in the aspirin group and 1.6% in the non-aspirin group. This means that for the unhealthiest group, treating 78 patients with aspirin could prevent one case of colorectal cancer over 10 years, while it would take treating 909 patients to prevent one case in the healthiest group.
Lifestyle scores were based on factors like body mass index, smoking and alcohol use, physical activity, and diet quality.
The study’s findings suggest that aspirin could significantly lower the elevated risk of colorectal cancer in those with multiple risk factors. People with healthier lifestyles already have a lower baseline risk, so the benefit of aspirin is still present but less noticeable.
The researchers believe that healthcare providers might consider recommending aspirin more strongly to patients with less healthy lifestyles. While the study included people taking regular standard-dose aspirin, other studies support using a daily low-dose aspirin for prevention.
Previous research suggests that aspirin can reduce the production of certain proteins that promote cancer development. It may also block cell growth pathways, influence the immune response against cancer, and prevent the development of blood vessels that feed cancer cells.
The study did not assess potential side effects of daily aspirin use, such as bleeding. Although the study controlled for various risk factors, as it was observational, there could have been other factors influencing the findings.
In conclusion, regular aspirin use might help reduce colorectal cancer risk, particularly in individuals with higher lifestyle-related risk factors. However, it is important to weigh the benefits against potential risks like gastrointestinal bleeding, and consult healthcare providers for personalized advice.
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The research findings can be found in JAMA Oncology.
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