Aspirin Therapy to Prevent Gastrointestinal Cancers

Aspirin Therapy to Prevent Gastrointestinal Cancers

How aspirin therapy may help reduce the risk of colorectal and esophageal cancers.

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

Before getting into the reason why aspirin may reduce the risk of some cancers, it’s important to note that long-term aspirin use has been associated with several side effects, including stomach irritation, gastric (stomach) bleeding and peptic ulcers. You should speak with your healthcare provider before starting aspirin therapy or any other medication.

Aspirin and gastrointestinal cancers
Gastrointestinal cancers are cancers 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— are 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 over 140,000 new cases of colorectal cancers in 2018.

A number of studies over the past 30 years have suggested that long-term, regular aspirin use reduces the risk of a person developing colorectal cancer as well as 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), 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 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? Healthcare experts are not sure, and this question is not well studied, at least at the moment. 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 any 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. These include quitting smoking or using any other tobacco products (if you use tobacco products), maintaining a healthy bodyweight, 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 healthcare provider for recommended screenings, to spot any symptoms of cancer early.

Should you take aspirin?
The U.S. Preventive Services Task Force recommends low-dose aspirin for people between the ages of 50 and 69 years to prevent both cardiovascular disease and colorectal cancer. However, the recommendations stress the idea that this is a decision that should be make on an individual basis, with considerations to a person’s risk of these health conditions, life expectancy and their risk of gastrointestinal bleeding.

The decision of whether or not to take low-dose aspirin therapy is a question to discuss with your healthcare provider, who can help you understand aspirin’s risks and benefits against your own specific risk factors for gastrointestinal cancer.

Medically reviewed in January 2020.

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