Can Aspirin Therapy Prevent Gastrointestinal Cancers?

Research suggests that the common pill may help reduce the risk of colorectal and esophageal cancers.

Bottle of white pills

Medically reviewed in November 2021

Updated on April 29, 2022

Acetylsalicylic acid, better known as aspirin, is commonly used to reduce fevers and inflammation, and relieve minor aches and pains. For some people with heart disease risk factors, it’s also taken daily as an anti-clotting agent that reduces chances of heart attacks and strokes. Some research suggests that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) could also help reduce the risk of some cancers, including gastrointestinal cancer.

Despite the possible benefits, it’s important to note that long-term aspirin use has been associated with several serious side effects, including stomach irritation, gastric (stomach) bleeding, and peptic ulcers. Be sure to speak with your healthcare provider (HCP) before starting aspirin therapy or any other medication.

Aspirin and gastrointestinal cancers
Gastrointestinal cancers are those that begin in the digestive system, and include cancers of the esophagus, stomach, bile ducts, small intestine, colon, rectum, peritoneal cavity, anus, pancreas, and liver. Of these cancers, colorectal cancer—cancer of the colon and rectum—is believed to be the most common. Colorectal cancers are the fourth most common type of cancer in the United States, and data published by the National Cancer Institute estimates approximately 151,030 new cases of colorectal cancers in 2022.

Some studies over the past 30 years have suggested that long-term, regular aspirin use reduces the risk of a person developing colorectal cancer. More research is being done on the link between aspirin use and possible decreased risk of other types of gastrointestinal cancer, including stomach cancer, esophageal cancer, and cancers of the liver and pancreas.

How low-dose aspirin might reduce gastrointestinal cancer risk
According to a study conducted by Oregon Health and Science University (OHSU) in collaboration with Oregon State University (OSU) and published in 2017 in the American Journal of Physiology—Cell Physiology, aspirin may reduce colorectal cancer risk because of the way it affects blood cells called platelets.

Platelets help blood to clot, which stops bleeding. Cancer cells circulating in the blood can interact with platelets, causing platelets to increase levels of a certain protein that helps cancer cells survive and spread. Aspirin inhibits this protein, making it more difficult for cancer cells to proliferate.

Other research has focused on how aspirin inhibits COX-1 and COX-2 enzymes, which are part of the body’s inflammatory response. Prolonged inflammation has been shown to cause cellular mutations that can result in precancerous growths in the lower gastrointestinal tract.

Aspirin and other cancers
Can aspirin help reduce the risk of other cancers? The evidence is not clear-cut. There have been observational studies that have looked at a possible link between aspirin therapy and lower risks of melanoma, prostate cancer, and ovarian cancer, but more research is needed before recommendations can be made.

Cancer prevention
While there is still more research needed regarding aspirin and cancer prevention, there are several documented ways to prevent cancer that you can employ today. These include quitting smoking or other tobacco products, maintaining a healthy body weight, limiting your consumption of alcohol, exercising regularly, and eating a nutritious diet that focuses on whole foods, vegetables, and sources of lean protein. It also means keeping regular appointments with your HCP for recommended screenings to spot any symptoms of cancer early.

Should you take aspirin?
In its most recent guidelines on aspirin, published in April 2022, the U.S. Preventive Services Task Force no longer recommends the use of low-dose aspirin to prevent colorectal cancer. The group concluded that the available evidence does not definitively show that low-dose aspirin reduces new cases or death from the disease. People concerned about colon cancer risk should talk with their HCP and seek recommended colon cancer screening.

As for gastrointestinal cancer overall, the question of whether to take low-dose aspirin therapy is one you should discuss with your HCP. They can help you weigh aspirin’s risks and benefits against your own risk factors for gastrointestinal cancer.

Article sources open article sources

Rothwell PM, Price JF, Fowkes FGR, et al. Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet. 2012;379(9826):1602-1612.
Cuzick J, Otto F, Baron JA, et al. Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement. Lancet Oncol. 2009;10(5):501-507.
García Rodríguez LA, Soriano-Gabarró M, Bromley S, Lanas A, Cea Soriano L. New use of low-dose aspirin and risk of colorectal cancer by stage at diagnosis: a nested case-control study in UK general practice. BMC Cancer. 2017;17(1):637.
Flossmann E, Rothwell PM, British Doctors Aspirin Trial and the UK-TIA Aspirin Trial. Effect of aspirin on long-term risk of colorectal cancer: consistent evidence from randomised and observational studies. Lancet. 2007;369(9573):1603-1613.
Jayaprakash V, Menezes RJ, Javle MM, et al. Regular aspirin use and esophageal cancer risk. Int J Cancer. 2006;119(1):202-207.
Loomans-Kropp HA, Pinsky P, Umar A. Evaluation of aspirin use with cancer incidence and survival among older adults in the prostate, lung, colorectal, and ovarian cancer screening trial. JAMA Netw Open. 2021;4(1):e2032072.
Loomans-Kropp HA, Pinsky P, Cao Y, Chan AT, Umar A. Association of aspirin use with mortality risk among older adult participants in the prostate, lung, colorectal, and ovarian cancer screening trial. JAMA Netw Open. 2019;2(12):e1916729.
Mitrugno A, Sylman JL, Ngo AT, et al. Aspirin therapy reduces the ability of platelets to promote colon and pancreatic cancer cell proliferation: Implications for the oncoprotein c-MYC. Am J Physiol Cell Physiol. 2017;312(2):C176-C189.
National Cancer Institute. Can Taking Aspirin Help Prevent Cancer? Updated October 7, 2020.
US Preventive Services Task Force. Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327(16):1577–1584.

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