Researchers say people who took two doses of aspirin every week had a lower risk for hepatocellular carcinoma.
Aspirin may do more than just relieve a headache.
It may also reduce the risk of a common form of liver cancer.
Researchers associated with Massachusetts General Hospital (MGH) say evidence from their study suggests that aspirin can reduce the risk of developing primary liver cancer, also known as called hepatocellular carcinoma (HCC).
Their findings were published in the October issue of the Journal of the American Medical Association, Oncology.
Researchers analyzed data from two long-term studies that started in the 1980s.
Participants, who are nurses and health professionals, biannually reported their medication intake for nearly 30 years.
About 134,000 participants — 46,000 women and 88,000 men — said they took aspirin regularly.
The researchers concluded that taking at least two doses of aspirin — 325 milligrams (mg) each — a week for five years or more led to a significantly reduced risk of developing HCC.
Taking that minimum dosage showed a 49 percent reduction in the relative risk, while taking that same amount for five years or more saw the relative risk drop by 59 percent.
If aspirin use was halted, the decreased risk for developing HCC ended after eight years.
Dr. Tracey Simon, a clinic research fellow and soon-to-be faculty member at MGH was the study’s lead author.
She told us that the analysis is a great first step in figuring out if taking aspirin can help prevent HCC.
“It’s an observational study, so I can’t say anything about the causality,” she said. “But it’s building a case.”
Dr. David Bernstein, chief of gastroenterology at Northwell Health in New York, agreed.
He told us that the analysis brought forth by Simon and her team is intriguing.
“Overall, this is a well-performed prospective longitudinal study that has made the observation that long-term aspirin use may decrease the risk of HCC,” he said.
According to the Mayo Clinic, HCC is the most common type of liver cancer.
It can develop due to a number of reasons, cirrhosis of the liver being the most common.
But the disease can also be caused by hepatitis B or C infection, alcohol use disorder, or nonalcoholic fatty liver disease (NAFLD).
There are a number of treatment methods for HCC.
They include surgery, chemotherapy, and radiation.
However, according to Simon, HCC is often diagnosed in the late stage, which doesn’t give the patient or physician many options.
Once a person is diagnosed with HCC, the survival rate is usually less than a year, according to the study.
It’s the role of NAFLD in the development of HCC that has Simon the most worried.
According to a report in World Journal of Clinical Oncology (WJCO), NAFLD is now the leading chronic liver disorder in the developed world, with a worldwide prevalence ranging from 6 percent to 35 percent.
That same study also said that “NAFLD associated HCC is the second most common indication for liver transplant for HCC… in the United States since 2006, increasing four fold since 2002.”
The obesity, diabetes connection
NAFLD can be caused by obesity and diabetes, both of which are on the rise.
According to the most recent National Health and Nutrition Examination Survey, nearly 19 percent of children and nearly 40 percent of adults were obese in 2015–2016.
Diabetes is on the rise as well, particularly in children, according to a 2017 report from the CDC.
From 2002 to 2012, the rate of new diagnosed cases of type 1 and type 2 diabetes increased by about 2 percent and 5 percent, respectively.
According to a study published in Hepatology in January 2018, NAFLD cases are forecasted to increase 21 percent, from 83 million in 2015 to 100 million in 2030.
Also troubling for Simon is that NAFLD symptoms are invisible, so the disease can go undetected for years.
“People don’t even know they have it” she said, noting that right now there’s no formal recommendation for general practitioners to screen for it.
Aspirin, as a means to reduce the risk of liver cancer, has been studied in the past, according to Simon.
She said previous studies on lab animals have suggested that the regular use of anti-inflammatory medication may help reduce the risk.
This new study is the first to give a specific dosage.
“We see aspirin as anti-inflammatory,” she said, adding that the drug is recommended to prevent heart disease and colon cancer.
Still, there isn’t enough compelling evidence for physicians to make that same recommendation for liver disease.
“It’s still too early,” Simon said. “It should not change clinical practice right now.”
Bernstein agreed.
He said the current study doesn’t differentiate clinical description of HCC patients, the total number of patients in the cohort with cirrhosis, nor did it control for the dose of aspirin.
These and other factors need to be included and analyzed in future studies in order for more meaningful outcome.
“Before we can conclude that long-term aspirin use does in fact decrease the risk of HCC development, controlled trials must be performed,” he said.
Simon concurred that much more study is needed.
She’d like to see more analysis on subgroups of people with liver disease that take into consideration how it was contracted.
But for now she’s pretty excited that the current study is receiving much needed attention.
“There’s so little study for HCC prevention so to potentially reduce the risk by 50 percent is pretty exciting for us,” she said.
The bottom line
People who took a minimum dose of aspirin for more than two decades showed a reduced risk of nearly 50 percent for developing liver cancer, according to a new analysis.
Researchers speculate that the anti-inflammatory drug can help stave off the development of liver cancer, particularly in those who have markers for developing liver disease.
These markers includes hepatitis B and C, alcohol use disorder, cirrhosis, or nonalcoholic fatty acid liver disease.
But the research is still in the early stages. Experts say more studies are needed before physicians can recommend this prevention method.