Aspirin Use Linked to Reduced Colorectal Cancer Risk, Especially Among Those with Unhealthy Lifestyles

A comprehensive study suggests that regular aspirin use can offer a greater absolute reduction in the risk of colorectal cancer (CRC), with the most significant benefit seen among individuals with less healthy lifestyles. This finding emerges from an analysis of long-term data from the Nurses’ Health Study and the Health Professionals Follow-Up Study, encompassing 107,655 participants over several decades.

The research, published in JAMA Oncology, examined the use of aspirin and its association with CRC risk across various lifestyle factors. Previous data had established the link between aspirin use and a lowered incidence of colorectal cancer, but there had been less clarity on which individuals might benefit most from its use. The study sought to fill this gap by considering lifestyle factors like body mass index, alcohol intake, physical activity, diet, and smoking history.

In participants who used aspirin regularly, defined as two or more standard 325 mg tablets per week, the 10-year cumulative CRC incidence was 1.98%, compared with 2.95% in those who didn’t use aspirin. This translates into an absolute risk reduction of 0.97%. Notably, the reduction associated with aspirin use was most pronounced among individuals with the unhealthiest lifestyles, diminishing progressively with healthier scores.

For the unhealthiest lifestyle group (scores 0 to 1), the 10-year absolute risk reduction associated with aspirin use was 1.28%, whereas for the healthiest group (scores 4 to 5), the reduction was merely 0.11%. The number needed to treat with aspirin ranged from 78 for the unhealthiest group to 909 for the healthiest group. This means that the preventive benefits of aspirin were significantly skewed towards people with less healthy behaviors, particularly those with higher body mass index and smoking.

The study’s authors note that aspirin may modulate cancer risk through several mechanisms, including the inhibition of inflammatory signals, alteration of critical cell signaling pathways, and modulation of immune responses. Although aspirin use has been associated with a 20% to 30% reduction in CRC risk, the potential for adverse effects, such as bleeding, has been a concern. The findings from this study could prove essential in identifying the individuals who might derive the most considerable benefit from aspirin for cancer prevention, potentially influencing medical guidelines and personalized health recommendations.

The study stresses the importance of lifestyle factors in determining the risk and prevention of colorectal cancer. Regular aspirin users saw a similar relative reduction in CRC incidence, regardless of their lifestyle profiles, but the absolute benefits were more substantial among those with an unhealthier baseline.

These findings highlight the prospect of using aspirin as a preventative measure, particularly for individuals with additional lifestyle risk factors. However, the study also acknowledges certain limitations, including a predominantly white population of health professionals, which may not generalize to the broader community. Self-reported data and the absence of adverse outcome assessments are also potential drawbacks to consider.

For more details on this significant research, you can access the full article here.

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