A new study from Sweden has found that aspirin could help prevent the return of colon and rectal cancer after surgery—but only in certain patients.
Researchers at Karolinska Institutet and Karolinska University Hospital ran a large clinical trial to find out how a low daily dose of aspirin affects cancer recurrence in people with specific genetic changes in their tumors.
Colon and rectal cancer affect nearly two million people around the world each year. Unfortunately, up to 40% of these patients will later develop cancer that spreads, known as metastases. This makes the disease harder to treat and more dangerous.
Previous studies had suggested that aspirin might lower the chances of certain cancers returning, especially in people whose tumors have changes in genes related to a process called the PIK3 signaling pathway. These genes control how cells grow and divide.
When they are faulty, they can cause cells to grow out of control, leading to cancer. However, earlier studies were not conclusive, and no randomized trials had tested this idea—until now.
The new trial, called the ALASCCA study, involved more than 3,500 patients with colon or rectal cancer from 33 hospitals in Sweden, Norway, Denmark, and Finland. After surgery, patients whose tumors showed a mutation in the PIK3 pathway were randomly assigned to take either 160 mg of aspirin or a placebo every day for three years.
The results were impressive. Among the patients with the genetic mutation, those who took aspirin had a 55% lower risk of cancer coming back compared to those who got a placebo.
Professor Anna Martling, the study’s lead author, explained that this is an exciting step forward in personalized medicine. “This is a clear example of how we can use genetic information to personalize treatment and at the same time save both resources and suffering,” she said.
The researchers believe aspirin works in several ways. It lowers inflammation in the body, reduces the activity of platelets (tiny blood cells that can help cancer spread), and slows tumor growth. Together, these effects create a less favorable environment for cancer to grow again.
Even though scientists do not yet fully understand every detail of how aspirin works in this context, the study results strongly support using it for patients with the right genetic profile. Since aspirin is inexpensive and widely available around the world, this finding could make a big difference in global cancer treatment.
In summary, this research provides strong evidence that aspirin may be a useful and low-cost way to prevent colon and rectal cancer from returning after surgery in people with a certain genetic mutation. It also shows how genetic testing can help doctors choose better treatments for individual patients.
The study is published in the New England Journal of Medicine.
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