Aspirin Use May Improve Survival in Bladder, Breast Cancer

Regular aspirin use may improve survival in older patients with bladder or breast cancer, but more research is still needed, according to Holli Loomans-Kropp.

Loomans-Kropp, who holds a postdoctoral degree, is an NCI DCP Cancer Prevention Fellow at the National Cancer Institute, and recently published a study in JAMA Network Open analyzing aspirin’s possible relationship between cancer outcomes. She and her team analyzed data of 139,896 patients that was collected between 1993 and 2001.

While they did not find any correlations between aspirin use and cancer diagnoses or between aspirin use and outcomes for other cancer types (prostate, lung, colorectal, ovarian, esophageal, gastric, pancreatic and uterine), there was a trend toward better survival for aspirin users with breast or bladder cancer.

“[Increased survival] was primarily strongest amongst those who took aspirin three or more times a week. However, we did see an effect with any aspirin use amongst these two groups,” said Loomans-Kropp in an interview with CURE®.

This study did not look at how aspirin may improve bladder and breast cancer outcomes, but Loomans-Kropp pulled upon previous research regarding cyclooxygenase-2 (COX-2). COX-2 is an inflammatory enzyme, and inflammation may play a role in certain cancer types. Aspirin works to decrease inflammation by blocking COX-2.

“There have been studies published previously that have looked at cyclooxygenase expression within breast and bladder cancer. This is one of the primary mechanisms in which aspirin actually works – it’s a cyclooxygenase-2 inhibitor. So, it could be that if there are elevated levels of COX-2 in these types of cancers, [aspirin] could be working to help prevent that,” she said.

But before patients rush out to start a new aspirin regimen, they should talk to their health care team first, especially since Loomans-Kropp said that more research is needed on this topic.

Loomans-Kropp said she hopes that there will be randomized trials (where one group is assigned to take aspirin and the other group is not given aspirin) in the future that can better analyze any possible relationships between aspirin use and cancer outcomes.

“There is definitely evidence provided by our study, but it is not enough to suggest anything clinical, as it was a secondary analysis,” she said. “Other randomized clinical trials are required to be able to say anything more definitively,” she said. “There’s still a lot of information out there that we can mine to keep adding support [to our findings] through currently existing trials … but the gold standard is still a randomized clinical trial. That would be the ideal way to move forward.”

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