Daily aspirin therapy is often prescribed to prevent heart disease and stroke, and there is strong evidence that it can help prevent colorectal cancer in certain people. Aspirin’s preventive benefits have been tested in other cancers without definitive findings, but now a study suggests that taking the drug once a day can reduce the risk of getting liver cancer from hepatitis B.
Hepatitis B is a viral infection that attacks the liver. The virus can be contracted through contact with an infected person’s blood or other bodily fluid. Death from the hepatitis B virus (HBV) is commonly due to the development of cirrhosis (scarring of healthy liver tissue) or hepatocellular carcinoma (liver cancer).
“Liver cancer is the second leading cause of cancer death worldwide, and HBV is the most prevalent risk factor in our region,” says Teng‐Yu Lee, M.D., Ph.D., a researcher in the Department of Gastroenterology at Taichung Veterans General Hospital, in Taiwan, and lead investigator in the study. “HBV‐related liver cancer is therefore a major public health issue with a severe socioeconomic impact.”
Investigating the Link Between Aspirin and Cancer
“Aspirin has been investigated to explore its chemopreventive effect in cancers that are related to chronic inflammation, particularly in the prevention of colorectal cancer,” said Lee. “However, clinical evidence supporting the chemopreventive effect of aspirin therapy on liver cancer remains limited. Therefore, we conducted a large‐scale cohort study to evaluate the association of aspirin therapy with HBV‐related liver cancer.”
The study, presented at a recent meeting held by the American Association for the Study of Liver Diseases
(AASLD) in Washington, D.C., was conducted by researchers at Taichung Veterans General Hospital; E‐Da Hospital in Kaohsiung, Taiwan; Fu Jen Catholic University in New Taipei City, Taiwan; and National Taiwan University Hospital in Taipei.
The researchers reviewed medical records from Taiwan’s National Health Insurance Research Database between 1998 and 2012 for their study. They screened records of 204,507 patients with chronic HBV, and excluded patients with other forms of infectious hepatitis.
After excluding patients with liver cancer before the follow‐up index dates, 1,553 patients who had continuously received daily aspirin for at least 90 days were randomly matched 1:4 with 6,212 patients who had never received anti‐platelet therapy. The researchers analyzed both cumulative incidences of and hazard ratios for hepatocellular carcinoma development after adjusting for the risk of death from other causes. Cumulative incidence of liver cancer in the group treated with aspirin was significantly lower than that in the untreated group over five years.
One Step Closer to Addressing a Serious Global Health Issue
Liver cancer is a pressing global public health issue. According to AASLD’s “Guidelines for Treatment of Chronic Hepatitis B,” an estimated 240 million people worldwide have chronic HBV, with the highest prevalence of the virus in Africa and Asia.
In the U.S., the Centers for Disease Control (CDC) estimate that, in 2014, there were 19,200 new HBV infections. The actual number of cases may be higher, the CDC website says, because many people don’t know they are infected or may not have symptoms and therefore never seek the attention of medical or public health officials.
“For effectively preventing HBV‐related liver cancer, the findings of this study may help hepatologists treat patients with chronic HBV infection in the future, particularly for those who are not indicated for antiviral therapy. We are pursuing prospective investigations for further confirming the findings,” says Lee.
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