Elsevier

Seminars in Oncology

Volume 41, Issue 3, June 2014, Pages 397-401
Seminars in Oncology

Prevention and Treatment of Cancer With Aspirin: Where Do We Stand?

https://doi.org/10.1053/j.seminoncol.2014.04.012Get rights and content

Aspirin is arguably the synthesized drug that has been used most commonly in human history. Aspirin was originally developed and marketed for the treatment of inflammatory disorders at the end of the 19th century, but its mechanism of action remained unknown until the second half of the 20th century. Since the latter part of the 20th century aspirin also has been used for the primary and secondary prevention of cardiovascular diseases given its anti-thrombotic properties. An association between intake of aspirin and decreased cancer risk was identified in the past decades. Whether aspirin can be used as an anticancer agent in patients with a diagnosis of cancer was unknown until recently. Recent studies suggest that aspirin might provide therapeutic benefit in the adjuvant treatment of certain forms of cancer. This review provides a critical update on this topic, which has potential implications for oncologists and their patients.

Section snippets

Epidemiological Evidence

Multiple retrospective studies on inflammation and cancer have been published since the late 1980s suggesting a preventive role of anti-inflammatory drugs, especially aspirin.6 The effect of long-term use of aspirin on the development on colorectal cancer incidence and mortality was analyzed recently by Rothwell and collaborators.7 In a combined analysis of four randomized trials designed for the primary or secondary prevention of cardiovascular events, it was found that use of aspirin at doses

Adjuvant Treatment of Colorectal Cancer with Aspirin

Among the 142,000 patients diagnosed with colorectal cancer in the United States in 2013, it is estimated that in 72% of cases the tumor arises from the colon and in 28% of cases from the rectum.30 Colorectal cancer is predominantly a disease affecting older individuals as 90% of new cases and 94% of deaths occur in individuals aged 50 and older. In the 1980s 5-fluorouracil–based adjuvant chemotherapy became the standard of care for resectable stage III colorectal cancer and reduced mortality

Conclusions and Future Directions

Retrospective analyses of randomized studies designed to assess the effect of aspirin on cardiovascular events strongly suggest that intake of aspirin is associated with decreased incidence of cancer. While a randomized controlled study showed that the intake of 600 mg aspirin per day for a mean of 25 months substantially reduces the incidence of colorectal cancer in patients with hereditary colorectal cancer (Lynch syndrome),44 such data are not yet available with respect to the use of aspirin

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      Prospective studies are in progress to confirm its anticancer properties, both alone and combined with cytotoxic agents (Table 1). Aspirin, the oldest nonsteroidal anti-inflammatory drug (NSAID), elicits interesting anticancer properties, although most data derive from randomized trials analyzing the prophylactic and/or chemopreventive potential exploiting its anti-inflammatory activity [60–62]. Several studies reveal the benefits of daily aspirin on multiple aspects of cancer chemoprevention, by reducing both incidence and mortality [63], and metastasis in patients already diagnosed with cancer [64].

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    Conflicts of interest: none.

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