Aspirin use is associated with a decreased risk of developing hepatocellular carcinoma and of death from chronic liver disease, according to a study.
Hepatocellular carcinoma, the most common type of primary liver cancer, occurs mainly among patients with CLD, according to background information in the article, which appeared Nov. 28 on the website of the Journal of the National Cancer Institute. Previous reports have linked chronic inflammation due to CLD to cellular processes that could promote carcinogenesis.
Because of their anti-inflammatory properties and widespread use to prevent cardiovascular and cerebrovascular disease, nonsteroidal anti-inflammatory drugs, including aspirin and nonaspirin NSAIDs, are being investigated as cancer chemopreventive agents. NSAIDs have been shown to have a beneficial effect on risk of some cancers in clinical trials and observational studies. However, the relationship between NSAID use and risk of HCC and death from CLD has been unclear.
To investigate this relationship, Vikrant V. Sahasrabuddhe, MBBS, DrPH, of the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, and colleagues performed an observational study of 300,504 men and women ages 50 to 71 who were enrolled in the National Institutes of Health-AARP Diet and Health Study.
The researchers found the use of NSAIDs was associated with a reduced risk of HCC and a reduced risk of death from CLD compared with non-users. Study participants who used aspirin had a 41% reduced risk of HCC and a 45% reduced risk of death from CLD, while those who used non-aspirin NSAIDs experienced a 26% reduced risk of CLD mortality but no reduced risk of HCC.
“These associations are prominent with the use of aspirin, and if confirmed, might open new vistas for chemoprevention of HCC and CLD,” the authors concluded.
In an accompanying editorial, Isra G. Levy, MB, BCh, MSc, and Carolyn P. Pim, MD, both from the Department of Epidemiology and Community Medicine at the University of Ottawa in Canada, discussed how the known causes of chronic liver disease and primary liver cancer are hepatitis B and C virus infections and alcohol use, and noted links with obesity and diabetes have been suggested.
“We already have cheap, readily available interventions,” such as vaccines for hepatitis B and C virus, but “effective strategies for reduction of HBV and HCV are not always available or fully applied,” they wrote. Alcohol abuse and obesity are complex, multifactorial challenges that require interventions at the individual and system levels.
The writers concluded that although the potential of new chemopreventive strategies, such as NSAID use, merits study, the focus also should remain on improving established practices and interventions.
The study abstract is available at http://jnci.oxfordjournals.org/content/early/2012/11/28/jnci.djs452.abstract.