Aspirin and Cancer Prevention
Aspirin and Cancer Prevention
Source: Medscape , September 26, 2025.
1. Background
• Aspirin is well-known as an antiplatelet drug for cardiovascular disease but also shows anticancer effects, especially in preventing colorectal polyps and adenomas.
• Mechanism: COX inhibition → ↓ prostaglandins → ↓ polyp formation; also promotes apoptosis. Similar effects seen with other NSAIDs.
2. Evidence
• Meta-analysis (4 RCTs) = Randomized Controlled Trials : 6.7% absolute risk reduction in adenomas.
• Major trials (Physicians’ Health, Women’s Health, ASCEND, ARRIVE)
• Long follow-up required: benefit seen after 10–20 years.
• 2012 Lancet meta-analysis: ↓ colon cancer by 3.13/1000 people/year.
• Long-term mortality reduction (20 years): absolute risk reduction ~1.76%.
3. Limitations
• Bleeding risk starts immediately (GI bleeds, intracranial hemorrhage, bruising).
• Benefit requires ≥10 years of continuous aspirin use.
• Cancer screening (e.g., colonoscopy) more effective and cost-efficient than aspirin prophylaxis.
4. Conclusion
• Aspirin does reduce colorectal adenomas and long-term colon cancer risk.
• Not recommended for primary prevention of cancer; screening remains superior.
