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The relationship between aspirin consumption and hepatocellular carcinoma: a systematic review and meta-analysis
Shuai Wang1, Lijuan Zuo2, Zhaojin Lin3
1Department of Gastroenterology, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, China.
Insights
Aspirin consumption significantly lowers the risk of hepatocellular carcinoma (HCC) by 30%. This benefit applies to both healthy individuals and those with chronic liver disease, though gastrointestinal bleeding risks should be monitored.
Area of Science:
- Hepatology
- Oncology
- Gastroenterology
Background:
- Recent studies suggest a potential link between aspirin use and reduced risk of hepatocellular carcinoma (HCC).
- The precise correlation between aspirin consumption and HCC incidence requires further investigation.
Conclusions:
- Aspirin consumption is associated with a reduced risk of HCC in both the general population and individuals with chronic liver disease.
- Caution is advised regarding potential adverse events, particularly gastrointestinal bleeding, in patients with chronic liver disease undertaking aspirin therapy.
Background:
Recent studies have shown that aspirin consumption may reduce the risk of hepatocellular carcinoma (HCC), but their correlation is still not fully understood. This meta-analysis aimed to investigate the correlation between aspirin consumption and HCC.
Methods:
A systematic literature search was conducted on PubMed, Scopus, Cochrane Library, EMBASE, and Web of Science databases. The search period was from the establishment of the database to July 1, 2022 with no language restrictions.
Results:
A total of 19 studies including three prospective studies and 16 retrospective ones with 2,217,712 patients were included. Compared with those who did not take aspirin, those who took aspirin had a 30% lower risk of HCC (hazard ratio [HR] = 0.70, 95% confidence interval [CI] 0.63-0.76, I2 = 84.7%, P < 0.001). Subgroup analysis showed that aspirin significantly reduced the risk of HCC by 19% in Asia (HR = 0.81, 95% CI 0.80-0.82, I2 = 85.2%, P < 0.001) and by 33% (HR = 0.67, 95% CI 0.61-0.73, I2 = 43.6%, P = 0.150) in Europe and the U.S with no significant difference. Moreover, in patients with HBV or HCV infection, aspirin reduced 19% and 24% of the risk of HCC, respectively. However, aspirin administration might increase risks of gastrointestinal bleeding in patients with chronic liver disease (HR = 1.14, 95% CI 0.99-1.31, I2 = 0.0%, P = 0.712). Sensitivity analysis showed no significant difference of results after excluding individual studies, suggesting that the results were robust.
Conclusion:
Aspirin may reduce the risk of HCC in both healthy population and patients with chronic liver disease. However, attention should be paid to adverse events such as gastrointestinal bleeding in patients with chronic liver disease.
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