Aspirin Use Linked to Lower Risk of Some Cancers, Higher Risk of Others

Continuous use of low-dose aspirin is associated with an increased risk of certain cancers and a decreased risk of other cancers, according to research published in the Journal of the National Cancer Institute.

Researchers found that continuous use of low-dose aspirin was associated with an increased risk of cancer overall as well as an increased risk of lung, bladder, and other cancers.

However, continuous use of low-dose aspirin was associated with a decreased risk of melanoma, certain gastrointestinal cancers, certain hematologic malignancies, and other cancers.

For this study, the researchers analyzed data from more than 1.9 million patients enrolled in nationwide registries in Denmark. The patients were 40-70 years of age at baseline and were followed from 1997 through 2018.

Over a mean follow-up of 18.2 years, 30% of the patients filled at least 1 prescription for low-dose aspirin (75 mg to 150 mg), and 422,778 patients were diagnosed with cancer.

Continuous use of low-dose aspirin was associated with a higher risk of cancer in an age- and sex-adjusted analysis (hazard ratio [HR], 1.29; 95% CI, 1.28-1.31) and in a multivariable analysis adjusted for additional factors (HR, 1.04; 95% CI, 1.03-1.06).

The multivariable analysis also showed that continuous use of low-dose aspirin was associated with a significant reduction in the risk of several cancers and a significant increase in the risk of other cancers, as seen in the table below.

Cancers With Reduced Risk
Cancer Type	Any Continuous Aspirin Use	Aspirin Use for 5 or More Years	Aspirin Use for 10 or More Years
Colon cancer	Not significant	HR, 0.90; 95% CI, 0.84-0.95	HR, 0.86; 95% CI, 0.77-0.96
Leukemia	Not significant	HR, 0.81; 95% CI, 0.71-0.92	HR, 0.73; 95% CI, 0.57-0.92
Liver cancer	HR, 0.91; 95% CI, 0.83-0.99	Not significant	Not significant
Melanoma	HR, 0.92; 0.87-0.97	HR, 0.88; 95% CI, 0.80-0.97	HR, 0.83; 95% CI, 0.69-0.99
Meningioma	Not significant	HR, 0.71; 95% CI, 0.59-0.87	Not significant
Non-Hodgkin lymphoma	HR, 0.93; 95% CI, 0.88-0.98	HR, 0.82; 95% CI, 0.75-0.90	Not significant
Prostate cancer	Not significant	HR, 0.95; 95% CI, 0.90-0.99	HR, 0.88; 95% CI, 0.81-0.96
Cancer of the small intestine	HR, 0.78; 95% CI, 0.66-0.93	HR, 0.61; 95% CI, 0.43-0.86	Not significant
Thyroid cancer	Not significant	HR, 0.68; 95% CI, 0.48-0.96	Not significant
Cancers With Increased Risk
Cancer Type	Any Continuous Aspirin Use	Aspirin Use for 5 or More Years	Aspirin Use for 10 or More Years
Bladder cancer	HR, 1.16; 95% CI, 1.11-1.20	HR, 1.11; 95% CI, 1.03-1.19	HR, 1.18; 95% CI, 1.05-1.33
Brain cancer	HR, 1.25; 95% CI, 1.15-1.35	Not significant	Not significant
Lung Cancer	HR, 1.21; 95% CI, 1.18-1.24	HR, 1.23; 95% CI, 1.17-1.28	HR, 1.26; 95% CI, 1.16-1.36
Cancer of the renal pelvis or ureter	HR, 1.22; 95% CI, 1.05-1.42	Not significant	Not significant

The researchers also looked at high-dose aspirin (500 mg) use and found that consistent use was associated with a lower risk of cancer overall in a multivariable analysis (HR, 0.89; 95% CI, 0.85-0.93).

“Our findings should encourage studies of aspirin use in individuals at high risk for specific cancers,” the researchers concluded.

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Skriver C, Maltesen T, Dehlendorff C, et al. Long-term aspirin use and cancer risk: A 20-year cohort study. J Natl Cancer Inst. Published online November 15, 2023. doi:10.1093/jnci/djad231

This article originally appeared on Cancer Therapy Advisor