Led by Dr. Jae-tae Lee, the research team reviewed 19 systematic analyses published between 2016 and 2023. These studies assessed aspirin’s preventive effects across three categories: the general population, high-risk individuals predisposed to colorectal cancer, and patients undergoing or post-treatment. The findings, released this month, temper earlier optimism about aspirin’s role in cancer prevention.
Colorectal cancer is one of the leading causes of cancer-related deaths globally but is highly treatable when detected early. This underscores the importance of regular screening, such as colonoscopy. Although aspirin has gained attention for its possible preventive effects, questions remain about its safety and overall effectiveness.
Efficacy Varies by Risk Group
2. High-Risk Patients with Prior Adenomas: Among individuals with a history of colorectal adenomas—benign growths that make up the majority of precancerous polyps—aspirin significantly reduced the risk of recurrence. Since approximately 95% of colorectal cancers arise from these polyps, aspirin may offer preventive benefits in 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.
Significant Bleeding Risks
The study raised important safety concerns. Aspirin users in 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 individuals with chronic illnesses are especially vulnerable, requiring careful risk assessment.
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.
These findings reinforce the importance of established screening methods like colonoscopy for early detection. Although aspirin is widely used for pain relief, inflammation, and blood thinning, its broader use in cancer prevention remains unsupported by strong evidence.
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.
Kim Kuk Ju, HEALTH IN NEWS TEAM
press@hinews.co.kr
