Aspirin Use Associated with Lower Liver Cancer Risk and Chronic Liver Disease Mortality Rates

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(ChemotherapyAdvisor) –  Aspirin use – but not the use of other nonsteroidal anti-inflammatory drugs (NSAIDs) – is associated with a reduced risk of developing hepatocellular carcinoma (HCC), according to an analysis of data from a prospective cohort study, published in the Journal of the National Cancer Institute.

The analysis also found that aspirin and other NSAIDs are associated with lower chronic liver disease (CLD) mortality rates.

“Aspirin use was associated with reduced risk of developing HCC and of death due to CLD whereas nonaspirin NSAID use was only associated with reduced risk of death due to CLD,” reported lead author Vikrant V. Sahasrabuddhe, PhD, MBBS, of the US National Cancer Institute (NCI)'s Division of Cancer Epidemiology and Genetics in Rockville, MD.

The analysis included data from 300,504 men and women ranging from 50-71 years of age, who participated in the National Institutes of Health-AARP Diet and Health Study. The authors reported linking  participants' self-reported aspirin and nonaspirin NSAID use with registry-confirmed HCC diagnoses and death records, and statistically controlled for age, sex, ethnicity, tobacco and alcohol use, diabetes, and body-mass index (BMI).

Study participants who reported regular aspirin consumption experienced reduced HCC incidence (Risk Ratio [RR] 0.59; 95% CI, 0.45-0.77) and mortality due to CLD (RR = 0.55; 95% CI 0.45-0.67) compared to those who did not.  Users of nonaspirin NSAIDs also had a reduced risk of mortality due to CLD (RR = 0.74; 95% CI, 0.61-0.90). However, no association was found between HCC risk and nonaspirin NSAIDs (RR 1.08; 95% CI, 0.84-1.39).

“The risk estimates did not vary in statistical significance by frequency (monthly, weekly, daily) of aspirin use compared to non-use,” the authors pointed out.

In-vitro and mouse xenograft studies published in 2011 and 2012 previously suggested aspirin might induce apoptosis in HCC and might enhance doxorubicin-induced HCC cellular apoptosis, reducing tumor growth. Such studies offer “biological plausibility” for the new study's findings, the authors wrote.

Recent clinical studies have also suggested aspirin might prevent or slow progression in ovarian and prostate cancer, and that daily aspirin consumption is associated with lower overall cancer mortality, in addition to better-established chemoprevention benefits for gastrointestinal cancers.

Abstract

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