Aspirin May Offer Survival Advantage in Breast, Bladder Cancer

Aspirin use may be associated with improved survival for older patients with bladder and breast cancer, according to recent research published in JAMA Network Open.

Data from the Prostate, Lung, Colorectal, ad Ovarian Cancer Screening Trial was used, and it included 139,896 patients. Over the course of the study (1993-2001), more than 32,000 cancer diagnoses were reported, including 1751 bladder; 4552 breast; 332 esophageal; 397 gastric; 878 pancreatic; and 716 uterine.

While aspirin use was not associated with a change in incidence for any of the cancers, patients with bladder and breast cancer who used aspirin at least 3 times a week did see an increase in survival over those who did not.

“[Increased survival] was primarily strongest amongst those who took aspirin 3 or more times a week. However, we did see an effect with any aspirin use amongst these 2 groups,” said Holli Loomans-Kropp, PhD, MPH, study author and NCI DCP Cancer Prevention Fellow at the National Cancer Institute, said in an interview with Oncology Nursing News.

While this particular study did not look at the mechanism behind aspirin’s potentially protective effect in cancer, Loomans-Kropp pulled upon previous research regarding cyclooxygenase-2 (COX-2). COX-2 is an inflammatory enzyme, and inflammation may play a role in certain cancer types.

“There have been studies published previously that have looked at cyclooxygenase expression within breast and bladder cancer. This is one of the primary mechanisms in which aspirin actually works — it’s a cyclooxygenase-2 inhibitor. So, it could be that if there are elevated levels of COX-2 in these types of cancers, [aspirin] could be working to help prevent that,” she said.

Though aspirin may be beneficial, Loomans-Kropp emphasized that it is still important for patients to talk to their health care team before starting any new regimens.

“There is definitely evidence provided by our study, but it is not enough to suggest anything clinical, as it was a secondary analysis,” she said. “Other randomized clinical trials are required to be able to say anything more definitively.”

In the future, Loomans-Kropp hopes for randomized clinical trials that could more clearly define the relationship between aspirin use and cancer survival.

“There’s still a lot of information out there that we can mine to keep adding support [to our findings] through currently existing trials … but the gold standard is still a randomized clinical trial. That would be the ideal way to move forward,” Loomans-Kropp said.

Reference

Loomans-Kropp HA, Pinsky P, Umar A. Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. JAMA Network Open. 2021;4(1):e2032072. doi:10.1001/jamanetworkopen.2020.32072