The Role of Aspirin in Preventing Colorectal Cancer for Individuals with Unhealthy Lifestyles

Aspirin has long been recognized as an effective tool in the prevention of colorectal cancer (CRC). However, recent data has shed new light on the potential benefits of aspirin, particularly for individuals with unhealthy lifestyles. A study conducted by researchers analyzed the impact of regular aspirin use on CRC risk in individuals with varying lifestyle risk factors, such as smoking and higher body weight.

The methodology of the study involved analyzing data from over 100,000 participants in the Nurses‘ Health Study and Health Professionals Follow-Up Study. Participants were categorized based on their regular aspirin use, with those taking two or more standard 325-mg tablets per week considered regular users. A healthy lifestyle score was calculated for each participant, taking into account factors such as body mass index (BMI), alcohol intake, physical activity, diet, and smoking. The researchers then compared the incidence of CRC, absolute risk reduction (ARR) with aspirin use, and number needed to treat associated with regular aspirin use based on the participants‘ lifestyle scores.

Over the course of more than three million person-years of follow-up, 2544 new cases of CRC were documented. The study found that the 10-year cumulative incidence of CRC was significantly lower among regular aspirin users compared to non-users, with an ARR of 0.97%. Interestingly, the benefits of aspirin use were found to be greatest among individuals with the unhealthiest lifestyle scores, such as those with higher BMI and smokers. The number needed to treat with aspirin for 10 years to prevent one CRC case was also significantly lower for individuals with unhealthy lifestyles compared to those with healthier lifestyles.

„These results support the use of lifestyle risk factors to identify individuals who may have a more favorable risk-benefit profile for cancer prevention with aspirin,“ the authors concluded. The study, led by Dr. Daniel R. Sikavi from Massachusetts General Hospital and Harvard Medical School, was published in JAMA Oncology.

While the findings of this study are compelling, it is important to note some limitations. The study population consisted mainly of health professionals who were predominantly White, which may limit the generalizability of the findings. Additionally, lifestyle factors and aspirin use were self-reported, which could introduce measurement errors. Adverse outcomes potentially due to aspirin use or the presence of hereditary cancer syndromes were not systematically assessed in the study.

Overall, this study provides valuable insights into the potential benefits of aspirin for colorectal cancer prevention in individuals with unhealthy lifestyles. Further research is needed to confirm these findings and explore potential mechanisms underlying the interaction between aspirin use and lifestyle factors in CRC prevention.