Aspirin May Reduce Hepatocellular Carcinoma Risk

Taking an aspirin a day may help reduce the risk of hepatocellular carcinoma (HCC), the most common type of liver cancer, in patients with chronic hepatitis B (HBV), according to study findings published in JAMA Internal Medicine.

“Aspirin has been investigated to explore associations between its chemo-preventive effect and cancers that are related to chronic inflammation,” Taiwanese researchers wrote. “Clinical research has demonstrated that aspirin can reduce cancer risk, particularly in the prevention of colorectal cancer.”

To examine if aspirin is chemo-preventive — the use of a medication, vitamin or supplement to stop cancer from happening — researchers studied more than 10,000 patients. Of these patients, 7,690 patients (72.4%) were men and the mean age was 58.7 years.

The researchers found 2,123 patients who received daily aspirin therapy for a median duration of 3.1 years — nearly all (98%) took 100 milligrams or less. They were randomly matched with 8,492 patients who never received aspirin based on age, gender, cirrhosis, liver decompensation, diabetes, high blood pressure and high levels of fat particles in the blood.

More than 80% of the aspirin-treated group were on the medication for cardiovascular diseases, such as diabetes and high blood pressure; 41.2% had coronary arterial disease; 37.5% had cerebral vascular disease; and less than 10% had diagnoses other than cardiovascular disease, such as irregular heartbeat and peripheral vascular disease.

In addition, researchers took into consideration other possible chemo-preventive medicines, such as metformin and statins and nucleoside analogue (NA) therapy, which can be used to treat HBV.

They found a 29% reduction in risk of HCC in those who received daily aspirin compared with patients in the untreated group. Researchers also discovered that being male, older and having cirrhosis were associated with an increased risk of HCC. However, NA therapy and statin use were correlated with a decreased risk.

“Platelets play an important role in the pathogenesis of HBV-related liver disease by sustaining inflammation,” the researchers wrote. “Aspirin can block thromboxane A2 production and inhibit the pathways of platelet activation.”

More than 42,000 new cases of liver cancer will be diagnosed this year in the United States, according to Cancer.Net, the American Society of Clinical Oncology’s (ASCO) patient website. ASCO also reports that since 1980, incidence of liver cancer has tripled and that men are about three times more likely than women to receive a diagnosis of the disease.

“Our findings may be of help in future efforts to further improve the chemo-prevention of HBV-related HCC, and a proof-of-concept study is thus warranted,” the researchers wrote. “Before aspirin therapy is broadly adopted for HCC prevention in practice, a prospective trial should be conducted to assess its efficacy and safety.”