Daily Aspirin Reduces Liver Cancer Risk from Hepatitis B

Many patients take daily aspirin to help reduce their risk of heart disease. New findings from a study presented at The Liver Meeting suggest that daily aspirin may also decrease the risk of liver cancer related to chronic hepatitis B virus (HBV).

Currently, more than 240 million individuals have HBV around the world. Since the infection can cause serious liver damage, a majority of HBV-related deaths are the result of cirrhosis or hepatocellular carcinoma, according to the study.

Previous studies have found that aspirin may reduce the risk of HBV-related liver cancer, but clinical evidence was limited.

The authors of the current study conducted a nationwide cohort analysis in Taiwan to determine whether liver cancer could be mitigated by daily aspirin.

“Liver cancer is the second leading cause of cancer death worldwide, and HBV is the most prevalent risk factor in our region,” said lead investigator Teng‐Yu Lee, MD, PhD. “HBV‐related liver cancer is therefore a major public health issue with a severe socioeconomic impact.”

While current antiretroviral drugs have the potential to lower the risk of liver cancer, the authors said that they do not completely eliminate the risk. The authors also report that many patients with HBV cannot take antivirals. These factors highlight the need for another effective way to reduce the risk of liver cancer.

“Aspirin has been investigated to explore its chemopreventive effect in cancers that are related to chronic inflammation, particularly in the prevention of colorectal cancer,” Dr Lee said. “However, clinical evidence supporting the chemopreventive effect of aspirin therapy on liver cancer remains limited. Therefore, we conducted a large‐scale cohort study to evaluate the association of aspirin therapy with HBV‐related liver cancer.”

Included in the study were medical records for 1553 patients who had taken aspirin daily for at least 90 days. These patients were matched 1:4 with 6212 patients who never received the therapy. The authors examined incidences of liver cancer after adjusting for mortality.

The authors discovered that the prevalence of liver cancer was significantly lower among aspirin-treated patients compared with those who did not take the drugs.

Both the multivariate regression analysis and subgroup analyses showed that aspirin was linked to a lower risk of liver cancer, according to the study.

The authors reported that patients who were older, male, had cirrhosis, or had diabetes were more likely to develop liver cancer, while those taking nucleos(t)ide analogues or statins were at a lower risk, according to the study.

These results suggest that daily aspirin may be beneficial for patients with HBV, the authors concluded.

“For effectively preventing HBV‐related liver cancer, the findings of this study may help hepatologists treat patients with chronic HBV infection in the future, particularly for those who are not indicated for antiviral therapy. We are pursuing prospective investigations for further confirming the findings,” Dr Lee said.