New Evidence Supports Aspirin Use to Lower Risk of Ovarian Cancer, Liver Cancer

Low-dose aspirin users may have a lower risk of developing ovarian cancer and hepatocellular carcinoma (HCC), according to 2 new studies published in JAMA Oncology.

Previous studies have pointed to the potential protective benefits of aspirin use for certain diseases, with current recommendations that suggest its use to prevent heart disease and colorectal cancer. Research has suggested that the same benefits can be applied to ovarian and liver cancer.

In the ovarian cancer study, the researchers analyzed data from 2 cohorts: 93,644 women in the NHS and 111,834 in the NHS II. They evaluated timing, duration, frequency, and number of tablets used for standard-dose aspirin (325 mg), low-dose aspirin (100 mg or less), non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen.¹

Of the 205,498 women in both cohorts, 1054 developed ovarian cancer. The analysis found that daily low-dose aspirin use was associated with a 23% lower risk of ovarian cancer, whereas no association was identified for standard-dose aspirin use. Conversely, women who took non-aspirin NSAIDs, such as ibuprofen or naproxen, at least 10 tablets per week for several years, had an increased risk of developing the disease, according to the study.¹

“These findings appear to be consistent with case-control studies that show a reduced risk of ovarian cancer among regular users of low-dose aspirin,” the researchers concluded in the study.¹ However, they noted that more research needs to be done before recommending daily aspirin use for this reason.²

For the HCC study, Massachusetts General Hospital (MGH) investigators conducted a pooled analysis of 2 US cohort studies: the NHS and the Health Professionals Follow-up Study, including a total of 133,371 health care professionals who reported on aspirin use, frequency, dosage, and duration of use biennially since 1980 in women and 1986 in men.³

Over the 26-year follow-up period, 108 incident HCC cases occurred. Regular aspirin use, defined as 2 or more standard-dose tablets per week, was associated with reduced a HCC risk when compared with nonregular use, according to the study. Among those taking aspirin for 5 years or more, the relative risk was reduced by 59%. The data showed that HCC risk also declined progressively with increasing aspirin dose and duration of use compared with nonuse.³

“The longer duration of aspirin use could be necessary because primary liver cancer takes many years to grow. Aspirin may act at the earliest stages of cancer development, or even at precancerous stages, by delaying or preventing inflammation or liver fibrosis,” lead study author Tracey Simon, MD, a research fellow in the MGH Division of Gastroenterology, said in a press release.⁴ According to Dr Simon, the next step would be to study the effects of aspirin use in populations with established liver disease, since that group is already at risk for primary liver cancer.⁴

References

1. Barnard ME, Poole EM, Curhan GC, et al. Association of analgesic use with risk of ovarian cancer in the Nurses’ Health Studies. JAMA Oncology. 2018. Doi: 10.1001/jamaoncol.2018.4149

2. Evidence Mounts Linking Aspirin to Lower Risk of Ovarian Cancer [news release]. Moffitt Cancer Cancer’s website. https://moffitt.org/newsroom/press-release-archive/2018/evidence-mounts-linking-aspirin-to-lower-risk-of-ovarian-cancer/. Accessed October 9, 2018.

3. Simon TG, Ma Y, Ludvigsson JF, et al. Association between aspirin use and risk of hepatocellular carcinoma. JAMA Oncology. 2018. Doi: 10.1001/jamaoncol.2018.4154

4. Mass General-led study supports ability of regular aspirin use to reduce liver cancer risk [news release]. Massachusetts General Hospital. https://www.massgeneral.org/about/pressrelease.aspx?id=2301. Accessed October 9, 2018.