Aspirin Use Linked to Lower Risk of Colorectal Cancer Recurrence in Specific Patients

Published27 September 2025, 18:00

Health: An effective medication effective against colorectal cancer

A Scandinavian study reveals the benefits of aspirin in certain patients with a specific genetic mutation.

According to the researchers, it is the anti-inflammatory properties of aspirin that would protect relapses.

imago/Levine-Roberts

Daily aspirin intake could halve the risk of recurrences in some people with colorectal cancer, second deadliest cancer in the world after that of the lung. According to a study published in the «New England Journal of Medicine», A low dose would be enough to ensure this protective effect against relapses of a form of colorectal cancer representing a fifth of the cases.

To arrive at this conclusion, Swedish scientists have conducted double -blind tests, with some 600 patients aged 31 to 80 and treated in 33 hospitals from four Nordic countries: Denmark, Sweden, Finland and Norway. Result, after three years of follow -up, the patients treated with aspirin after the removal of their tumor had made half fewer relapses than those who had received a placebo.

The clinical trial focused specifically on patients with a genetic mutation called “PIK3CA”, which notably leads to a predisposition to colorectal cancer, but also makes more sensitive to the anti-inflammatory properties of aspirin, reportsThe Guardian. Some 15 to 20% of colorectal cancers are linked to this mutation.

Towards a generalization of genetic tests?

Previous studies had already demonstrated the benefits of aspirin in the prevention of several cancers, including the colorectal, but it is the first time that scientists have established this protective effect, also after surgical treatment that has been a tumor.

According to Professor Anna Martling, who led the trial at the Karolinska Institute in Stockholm, genetic tests should be carried out on all patients in colorectal cancer, in order to determine which patients have mutation and could be treated with aspirin. This, especially since this drug, known since the end of the 19th century, is easily available and extremely cheap.

Almost two million colorectal cancers each year

Nearly 2 million colorectal cancers are diagnosed each year on the planet, according to the World Health Organization.

In recent years, the incidence of colorectal cancer has increased sharply in those under 50, without, at this stage, an explanation for this explosion of cases. American actor Chadwick Boseman (“Black Panther”) died in 2020, at the age of 43. James van der Beekstar of the series “Dawson”, is currently fighting against the disease. He is 48 years old.

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What are microsatellite stable (MSS) tumors and why are they relevant to aspirin therapy for colorectal cancer recurrence?

Understanding the Connection: Aspirin and Colorectal Cancer

Recent research continues to solidify a compelling link between regular aspirin use and a reduced risk of colorectal cancer recurrence. However, it’s crucial to understand this isn’t a blanket advice. The benefits appear most pronounced in a specific subset of patients – those who have already been treated for colorectal cancer. This article delves into the specifics, exploring who might benefit, the potential risks, and what the current guidelines suggest.we’ll cover topics like aspirin therapy, cancer prevention, and post-cancer treatment.

Who benefits most from Aspirin After colorectal Cancer Treatment?

The protective effect of aspirin seems strongest in individuals with:

* microsatellite Stable (MSS) Tumors: This is a key factor. MSS colorectal cancers, representing roughly 85% of cases, respond more favorably to aspirin than those with microsatellite instability-high (MSI-H) tumors.

* Specific Genetic Biomarkers: Research indicates that certain genetic mutations within the tumor may predict a greater response to aspirin’s preventative effects. Ongoing studies are identifying these biomarkers.

* Stage II or Stage III Colorectal Cancer: Patients who have undergone treatment for these stages appear to experience the most meaningful reduction in recurrence risk with regular aspirin use.

* Deficiencies in the DNA Mismatch Repair (dMMR) pathway: While MSI-H tumors generally don’t respond as well, understanding the dMMR pathway is crucial for personalized treatment.

How Does Aspirin Reduce Colorectal Cancer Recurrence?

The exact mechanisms aren’t fully understood, but several theories exist:

* inhibition of Cyclooxygenase (COX) Enzymes: Aspirin blocks COX-1 and COX-2 enzymes, reducing the production of prostaglandins. These prostaglandins play a role in inflammation and cancer development. Inflammation and cancer are closely linked.

* Platelet aggregation Inhibition: Aspirin’s antiplatelet effects may prevent cancer cells from spreading (metastasis) by reducing the formation of blood clots. Metastasis prevention is a critical aspect of cancer treatment.

* Immune System Modulation: Emerging research suggests aspirin can influence the immune system, potentially enhancing its ability to recognize and destroy remaining cancer cells. Immune response and cancer is a growing area of study.

* Epigenetic changes: Aspirin may induce epigenetic modifications, altering gene expression in ways that suppress cancer growth. Epigenetics and cancer is a complex but promising field.

risks and Side Effects of Long-Term Aspirin Use

While promising,long-term aspirin use isn’t without risks. It’s vital to discuss these with your oncologist:

* Gastrointestinal Bleeding: This is the most common and serious side effect. The risk is higher in individuals with a history of ulcers or bleeding disorders. Aspirin and bleeding risk is a major concern.

* Hemorrhagic Stroke: Aspirin can increase the risk of bleeding in the brain.

* Kidney Problems: Long-term use may contribute to kidney damage, especially in those with pre-existing kidney disease.

* Allergic Reactions: Some individuals are allergic to aspirin.

Dosage and Duration: What Do the Guidelines Say?

Current guidelines (as of late 2025) generally recommend the following, always under the guidance of a physician:

* Dosage: Typically, a low-dose aspirin (81mg) is used for preventative purposes.

* Duration: The optimal duration of aspirin therapy after colorectal cancer treatment is still being investigated. Studies have examined periods ranging from 3 to 5 years.

* Individualized Approach: The decision to use aspirin should be highly individualized,considering the patient’s overall health,risk factors,and tumor characteristics. Personalized cancer treatment is becoming increasingly crucial.

Real-World Example: The ASPREE Trial & Subsequent Research

The ASPREE (Aspirin in Reducing Events in the elderly) trial, while primarily focused on cardiovascular disease, provided valuable insights into aspirin’s effects. While it didn’t show a significant overall benefit in preventing cardiovascular events, subgroup analysis revealed a potential reduction in cancer-related deaths, particularly colorectal cancer, in certain populations.This sparked further investigation into aspirin’s chemopreventive properties. Follow-up studies, like the CAPP2 and JACKPOT trials, have focused specifically on colorectal cancer recurrence and are providing more definitive answers.

Benefits Beyond Recurrence: Potential for Primary Prevention

While this article focuses on secondary prevention (reducing recurrence), research also suggests aspirin may play a role in primary prevention – preventing colorectal cancer from developing in the first place. However, the risks and benefits must be carefully weighed, and aspirin is not currently recommended for primary prevention in the general population.

Practical Tips for Patients Considering Aspirin Therapy

* Open Interaction with Your Oncologist: This is paramount. Discuss your individual risk factors and potential benefits.

* Gastrointestinal Protection: If you have risk factors for GI bleeding, your doctor may recommend a proton