Led by Dr. Jae-tae Lee, the research team analyzed 19 systematic reviews published between 2016 and 2023, evaluating aspirin’s preventive benefits across three groups: the general population, high-risk individuals with conditions predisposing them to colorectal cancer, and patients treated for or in remission from colorectal cancer. The findings, released this month, temper enthusiasm for aspirin’s potential role in cancer prevention.
Colorectal cancer, a leading cause of cancer-related deaths worldwide, is highly treatable when caught early, making regular screenings like colonoscopy the cornerstone of prevention. While recent studies have fueled interest in aspirin’s possible protective effects, its efficacy and safety remain under scrutiny.
1. General Population: The evidence does not justify aspirin use for colorectal cancer prevention in people without elevated risk. Studies showed no consistent protective effect in this group.
2. High-Risk Patients with Prior Adenomas: In individuals with a history of colorectal adenomas—benign tumors that account for two-thirds to three-quarters of precancerous polyps—aspirin significantly reduced the risk of adenoma recurrence. Since 95% of colorectal cancers arise from these polyps, this finding suggests a potential benefit for this group.
3. Hereditary High-Risk Conditions: For patients with genetic disorders like familial adenomatous polyposis or Lynch syndrome, which heighten cancer risk across multiple organs, some studies reported a significant reduction in colorectal cancer incidence with aspirin use. However, the data remains inconclusive, and further research is needed.
4. Inflammatory Bowel Disease: In patients with conditions such as ulcerative colitis, where long-standing or extensive disease increases colorectal cancer risk, aspirin showed no link to reduced cancer incidence.
5. Post-Treatment Patients: For those undergoing colorectal cancer treatment or in remission, some studies suggested aspirin may lower the risk of adenoma recurrence, though the evidence is not definitive.
Overall, most studies reviewed by NECA found insufficient evidence to support aspirin as a broad preventive measure for colorectal cancer.
The study raised serious safety concerns. Aspirin users, across both general and high-risk groups, faced a 1.44 to 1.77 times higher risk of bleeding complications, including gastrointestinal and intracranial hemorrhages, compared to non-users. Older adults and those with chronic conditions are particularly vulnerable, warranting heightened caution.
Clinical Guidance
Dr. Min-jung Kim, head of NECA’s Healthcare Assessment Research Division, cautioned against routine aspirin use for colorectal cancer prevention in the general population. “For high-risk individuals or those with a history of colorectal cancer, decisions about aspirin should follow careful consultation with healthcare providers, balancing potential benefits against bleeding risks,” she said.
The findings reinforce the primacy of established screening methods, such as colonoscopy, for early detection and prevention. While aspirin—commonly used for pain relief, inflammation, or anticoagulation—may benefit specific high-risk groups, its broader use for cancer prevention lacks robust support.
NECA’s report calls for further studies to clarify aspirin’s role in hereditary high-risk populations and stresses the importance of individualized risk assessments in clinical practice.
Hashtags: ColorectalCancerPrevention, AspirinRisks, CancerResearch
Kim Kuk Ju, HEALTH IN NEWS TEAM
press@healthinnews.co.kr
