The study examined the link between the use of low-dose aspirin and the risk of colorectal cancer (CRC) by analyzing data from a nationwide cohort in Norway from 2004 to 2018. The study included records from over 2 million individuals aged 50 or older, tracking aspirin use through national registers and correlating it with cancer diagnoses and sociodemographic factors.
The results indicated that current aspirin use was associated with:
– a reduced CRC risk compared to never use (HR 0.87).
– protective effect was more significant for metastatic CRC (HR 0.79) than for earlier stages
-A longer duration of aspirin use was linked with lower CRC risk, with the most prolonged use (> five years) showing the most significant risk reduction (HR 0.84).
The potential mechanism underlying aspirin’s protective effect against CRC may involve its ability to inhibit pathways related to adenomatous polyposis coli (APC) gene mutations and subsequent adenoma formation.
Additionally, aspirin’s antiplatelet properties may contribute to the early detection of CRC through increased bleeding from cancerous lesions, leading to timely colonoscopy/FOBT tests and potentially better outcomes.
Despite the study’s strengths, including its large sample size and robust data from national registers, the study has limitations, being an observational study. These limitations include potential confounding factors not accounted for in the analyses, such as lifestyle factors and other unmeasured variables that could influence aspirin use and CRC risk.
In conclusion, the findings provide compelling evidence supporting the hypothesis that low-dose aspirin use is associated with a decreased risk of CRC.
Future randomized controlled trials are needed to confirm these observations and further elucidate the potential benefits of aspirin in CRC prevention, particularly in specific subgroups of the population.
Nafisi, Sara MSc1,2; Støer, Nathalie C. PhD1; Veierød, Marit B. PhD2; Randel, Kristin R. PhD3; Hoff, Geir PhD3,4,5; Löfling, Lukas PhD1; Bosetti, Cristina PhD6; Botteri, Edoardo PhD1,3. Low-Dose Aspirin and Prevention of Colorectal Cancer: Evidence From a Nationwide Registry-Based Cohort in Norway. The American Journal of Gastroenterology 119(7):p 1402-1411, July 2024. | DOI: 10.14309/ajg.0000000000002695