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BOSTON, MA – August 2, 2024 – A groundbreaking study led by researchers at Mass General Brigham has revealed that regular aspirin use is linked to a significant reduction in colorectal cancer risk, particularly among individuals with higher lifestyle-related risk factors for the disease. Published in JAMA Oncology, the study suggests a more targeted approach to preventive aspirin use could be beneficial.
Colorectal cancer remains the second-leading cause of cancer death in the United States, according to the National Cancer Institute. The U.S. Preventive Services Task Force had previously recommended daily low-dose aspirin for adults aged 50 to 59 to prevent both cardiovascular events and colorectal cancer. However, this recommendation was withdrawn in 2016 due to concerns about the increased risk of gastrointestinal bleeding associated with aspirin use.
The recent study, spearheaded by Dr. Andrew Chan, MD, MPH, Director of Epidemiology at the Mass General Cancer Center and gastroenterology Director of the Center for Young Adult Colorectal Cancer at Massachusetts General Hospital (MGH), aimed to pinpoint individuals who would benefit most from aspirin as a preventive measure.
Researchers analyzed health data from 107,655 participants from the Nurses’ Health Study and the Health Professionals Follow-Up Study. They assessed the colorectal cancer rates among those who regularly took aspirin compared to those who did not. Regular aspirin use was defined as taking either two or more standard-dose (325 mg) tablets per week or daily low-dose (81 mg) aspirin.
Results showed that participants who regularly took aspirin had a 10-year cumulative incidence of colorectal cancer of 1.98%, compared to 2.95% among those who did not use aspirin regularly. The benefit was notably pronounced among individuals with poorer lifestyle habits. Those with the lowest healthy lifestyle scores had a colorectal cancer risk of 3.4% without aspirin versus 2.12% with regular aspirin use. In contrast, individuals with the highest healthy lifestyle scores had cancer rates of 1.5% with regular aspirin use compared to 1.6% without it.
The study suggests that while aspirin’s protective effect is evident across all lifestyle groups, it is especially substantial for those with higher risk due to unhealthy behaviors. For the least healthy group, treating 78 patients with aspirin could prevent one case of colorectal cancer over a decade, whereas 909 patients would need to be treated in the healthiest group to achieve the same outcome.
“We aimed to identify individuals who would benefit most from aspirin to enable more personalized prevention strategies,” said Dr. Chan. “Our findings demonstrate that aspirin significantly lowers the elevated colorectal cancer risk among those with multiple risk factors.”
Dr. Long H. Nguyen, MD, MS, a co-senior author and physician investigator at MGH, noted that healthcare providers might consider recommending aspirin more strongly for patients with less healthy lifestyles. However, the study did not evaluate potential side effects, such as bleeding, associated with daily aspirin use.
Dr. Daniel Sikavi, MD, lead author of the study, emphasized that while prior studies suggest daily low-dose aspirin is effective for cancer prevention, the current study reinforces aspirin’s potential benefits, particularly for those at higher risk due to lifestyle factors.
The study underscores the need for personalized prevention strategies and highlights the complex interplay between lifestyle and preventive treatments.
For more information, refer to the full study: Aspirin Use and Incidence of Colorectal Cancer According to Lifestyle Risk, JAMA Oncology (2024). DOI: 10.1001/jamaoncol.2024.2503.
