Colorectal cancer stands as the second leading cause of cancer-related deaths worldwide. In the United States alone, it accounted for more than 52,500 deaths in 2023. The incidence of colorectal cancer is rising among younger populations doubling among individuals under 55 within the past decade.
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A 2023 American Cancer Society report found that around 20% of colorectal cancer diagnoses in 2019 were among Americans under 55, a rate double that in 1995.
This increase has made colorectal cancer the leading cause of cancer death in men under 50 and the second leading cause in women under 50.
The study was published in JAMA Oncology, analyzed data from over 107,655 individuals participating in the Nurses’ Health Study and the Health Professionals Follow-Up Study.
Participants were monitored for at least a decade, during which their aspirin usage and lifestyle factors were assessed.
Regular aspirin use in the study was defined as consuming two or more standard 325 mg pills or six or more low-dose 81 mg tablets weekly.
Regular aspirin users exhibited an 18% lower risk of developing colorectal cancer compared to non-users. The benefit was most among participants with less healthy lifestyles, those who smoked or had a BMI over 25 (considered overweight).
Participants with an unhealthy lifestyle had a 3.4% chance of developing colorectal cancer without aspirin, which decreased to 2.12% with aspirin use.
In contrast those with healthier lifestyles showed a minimal difference in colorectal cancer risk from 1.6% to 1.5% with aspirin use.
Aspirin is believed to inhibit pro-inflammatory signals that can lead to cancer development. It reduces the production of prostaglandins, which are pro-inflammatory proteins known to promote cancer.
While previous studies have shown aspirin’s potential in preventing colorectal cancer, the results have been inconsistent.
This study provides a clearer picture suggesting that aspirin’s benefits are more pronounced in populations with higher lifestyle-related risk factors.
Regular aspirin use was associated with a nearly 20% reduction in colorectal cancer risk. This benefit was especially pronounced in individuals with unhealthier lifestyles with a 38% reduction in risk among the least healthy group.
Participants with the least healthy lifestyles had a baseline 3.4% chance of developing colorectal cancer if they did not take aspirin. This risk was reduced to 2.1% with regular aspirin use.
Participants with the healthiest lifestyles had a colorectal cancer risk rate of 1.5% with aspirin and 1.6% without it. While aspirin’s benefits were less pronounced, they were still evident.
In the least healthy group 78 individuals would need to take aspirin for 10 years to prevent one case of colorectal cancer. In the healthiest group, 909 individuals would need to take aspirin to prevent one case over the same period.
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Aspirin acts as an anti-inflammatory agent. Inflammation is closely linked to the development of many cancers including colorectal cancer. By reducing inflammation, aspirin may lower the likelihood of cancerous growths forming.
Aspirin reduces the production of pro-inflammatory proteins known as prostaglandins. Prostaglandins can promote cancer development by encouraging cell growth and division.
Aspirin may block signaling pathways that cause abnormal cell growth. It may enhance the immune system’s ability to detect and eliminate cancer cells.
Aspirin potentially hinders the formation of new blood vessels that supply nutrients to tumors, thereby slowing cancer progression.
The study advocates for personalized prevention strategies rather than one-size-fits-all approaches.
Healthcare providers might consider recommending aspirin to patients with a less healthy lifestyle who are at higher risk for colorectal cancer.
The US Preventive Services Task Force previously recommended daily low-dose aspirin for individuals aged 50 to 59 to prevent cardiovascular events and colorectal cancer.
Concerns about gastrointestinal bleeding led to the withdrawal of this recommendation. This study may prompt a reevaluation for those with high-risk lifestyles.
Although aspirin shows promise, it is not without risks. Side effects like gastrointestinal bleeding must be carefully weighed against the benefits.
Before considering regular aspirin use, individuals should consult healthcare providers to assess their personal risk factors and overall health profile.
While aspirin may offer benefits, it should not replace healthy lifestyle choices. A balanced diet, regular exercise, avoiding smoking and moderating alcohol consumption remain crucial in reducing colorectal cancer risk.
The US Preventive Services Task Force recommends regular colorectal cancer screenings starting at age 45, continuing periodically until age 75.
Obesity rates have been steadily increasing with projections indicating that nearly half of the US population could be obese by 2030.
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