Daily Low-Dose Aspirin May Lower Colon and Rectal Cancer Recurrence
A daily low dose of aspirin could significantly decrease the likelihood of colon and rectal cancer recurrence in specific situations, according to findings from a new clinical trial.
Conducted by researchers at the Karolinska Institute and Karolinska University Hospital in Sweden, the study included 626 participants with stages 1 to 3 colon or rectal cancer, all of whom possessed particular genetic mutations in their tumors.
While earlier studies hinted that tumors with certain mutations—in particular, those in the PIK3 signaling pathway—might respond to aspirin, this is the first instance where such a hypothesis was examined in a randomized clinical trial.
Those taking daily aspirin experienced up to a 55 percent reduction in the chances of their cancer returning over three years compared to those receiving placebos. Specifically, there was a 7.7 percent chance of cancer recurrence among aspirin users, while the placebo group faced a recurrence rate ranging from 14.1 to 16.8 percent, depending on the mutation type.
“Aspirin is widely available and significantly cheaper than many modern cancer treatments, which is a great advantage,” noted Karolinska Institute surgeon Anna Martling.
Building on this trial and previous research, investigators believe aspirin helps combat cancer through three mechanisms: it reduces inflammation, slows tumor growth, and hampers platelet function, which cancer cells utilize for protection as they spread. Additionally, there’s speculation that aspirin may interfere with the PIK3 pathway, a key player in tumor development.
Future studies might clarify why aspirin seems effective in minimizing the risk of colorectal cancer recurrence.
“While we don’t fully grasp all the molecular connections yet, these results strongly indicate a biological basis and suggest that the treatment may be particularly beneficial for genetically defined patient subgroups,” Martling added.
With around 30 to 40 percent of the 2 million annual colorectal cancer diagnoses experiencing a recurrence, a simple preventative approach could potentially save numerous lives.
Low-dose aspirin has also been associated with various health benefits, such as a decreased risk of repeat heart attacks and strokes. However, it’s important to note that some studies have pointed out possible links between aspirin and increased risks of other health issues, including internal bleeding.
The encouraging aspect here is that tumors are already screened for significant mutations, which played a role in this study, affecting just over one-third of colorectal cancer cases. This subset could be targeted for potential treatment.
“Aspirin is being explored in a completely new context as a form of precision medicine,” Martling remarked. “This illustrates how we can leverage genetic information for personalized treatment while conserving resources and alleviating suffering.”
The findings have been published in the New England Journal of Medicine.
