The role of aspirin in cancer prevention

Michael J Thun1, Eric J Jacobs, Carlo Patrono

  • 1Epidemiology Research Program, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002, USA. michael.thun@ cancer.org

Insights

Daily low-dose aspirin use shows promise in reducing overall cancer incidence, potentially outweighing bleeding risks. Further research is needed to confirm these cancer-preventive benefits for the general population.

Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Current clinical guidelines for prophylactic aspirin use primarily focus on cardiovascular benefits versus bleeding risks.
  • Aspirin use is known to reduce colorectal cancer risk and adenomatous polyp recurrence, but benefits do not typically outweigh harms in average-risk populations.
  • Emerging evidence suggests daily aspirin may reduce the incidence of all cancers combined, even at low doses.

Purpose of the Study:

  • To review the mechanism of action of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).
  • To evaluate the evidence for aspirin's cardioprotective and cancer-preventive effects.
  • To assess whether cancer prevention benefits of aspirin could shift the risk-benefit balance in average-risk populations.

Main Methods:

  • Review of secondary analyses from cardiovascular trials.
  • Examination of the general mechanism of action for NSAIDs.
  • Analysis of evidence on aspirin's effects on cardiovascular health and cancer incidence.

Main Results:

  • Low-dose daily aspirin (75-100 mg) may reduce the incidence of all cancers combined.
  • Inhibition of platelet activation is hypothesized to mediate both cardioprotective and cancer-preventive effects.
  • A 10% reduction in cancer incidence could favor aspirin use in average-risk populations.

Conclusions:

  • Daily aspirin use, particularly low-dose, presents a potential strategy for cancer risk reduction.
  • The cancer-preventive benefits of aspirin may outweigh bleeding risks in average-risk populations, especially with a significant reduction in cancer incidence.
  • Further investigation into the dual cardioprotective and cancer-preventive mechanisms of aspirin is warranted.

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