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Aspirin and hepatocellular carcinoma risk in metabolic dysfunction-associated steatotic liver disease: nationwide

Juhee Ahn1,2, Moon Haeng Hur3, Hyunjae Shin3

  • 1Division of Data Science, College of Intelligent Software Convergence, University of Suwon, Hwaseong, Korea.

Clinical and Molecular Hepatology
|November 25, 2025
PubMed

Insights

Aspirin use may lower hepatocellular carcinoma (HCC) risk in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This finding, observed in large population and genetic studies, suggests a potential protective effect of aspirin for MASLD patients.

Area of Science:

  • Hepatology and Gastroenterology
  • Oncology
  • Pharmacology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern.
  • The risk of hepatocellular carcinoma (HCC) in MASLD patients is significant but influenced by various factors.
  • The role of aspirin in modulating HCC risk within the MASLD population remains incompletely understood.

Purpose of the Study:

  • To investigate the association between aspirin use and the risk of developing HCC in patients diagnosed with MASLD.
  • To leverage large-scale population data and genetic analyses to provide robust evidence.

Main Methods:

  • Retrospective cohort analysis of the Korean National Health Insurance Service (NHIS) database.
  • Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were employed for cohort balancing.
  • Mendelian randomization (MR) analysis using a genomic risk score (GRS) for aspirin metabolism in the UK Biobank (UKB) cohort.

Main Results:

  • In the NHIS cohort, aspirin use was linked to a significantly reduced risk of HCC in both the general population and MASLD patients.
  • The UKB cohort's MR analysis indicated that higher genetic predisposition to aspirin use was associated with a lower HCC risk in both overall and MASLD groups.
  • Sensitivity and subgroup analyses consistently supported the protective association.

Conclusions:

  • Evidence from population-based and genetic studies suggests a potential protective effect of aspirin against HCC in patients with MASLD.
  • Further research is warranted to validate these findings and explore the underlying mechanisms.
Abstract

Keywords:
AspirinFatty liverLiver cancerSalicylic acidUK Biobank

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