Aspirin Linked to Lower Metastasis in Esophageal, Colorectal Cancers

Aspirin use may be associated with lower rates of metastasis among patients with esophageal and colorectal cancer, researchers have found in two studies.

One study published in Diseases of the Esophagus drew on data from 190,655 patients with esophageal cancer. Of these patients, researchers found that 20,650 (10.8%) were aspirin users. They also established a 28.9% incidence of metastasis among aspirin users, versus a 38.7% incidence of metastasis among non-aspirin users.

Rates were similarly disparate when broken down by type of metastasis. Aspirin users versus non-aspirin users experienced a GI metastasis incidence of 14.2% and 20.6%, non-GI metastasis of 15.1% and 22% and lymphoid metastasis of 8.9% and 11.3%, respectively.

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“Our study noted that aspirin use is associated with a reduction in the rate of metastasis in patients with [esophageal cancer],” researchers noted in the study. “These [findings] support the use of aspirin in patients with [esophageal cancer] and suggest the need for further studies to understand the mechanism by which aspirin use reduces metastasis in patients with [esophageal cancer].”

More aspirin users were older than 65 than non-aspirin users (74.6% versus 57.4%), the study showed. Most were male (82.1% versus 77.8%), White (84% versus 78.4%) and had three or more comorbidities (94.9% versus 89.9%).

Aspirin users, researchers stated, also had higher incidence of diabetes (34.7% versus 22.4%, hypertension (79.4% versus 57.6%), chronic pulmonary disease (31% versus 25.8%), coronary artery disease (47.4% versus 18.1%), chronic kidney disease (15.3% versus 11%) and congestive heart failure (21.7% versus 13.4%), while non-aspirin users had higher rates of coagulopathy (1.3% versus 0.8%) and alcohol use disorder (7% versus 5.3%).

Similar Results Among Patients With Colorectal Cancer

Elsewhere, researchers in a smaller study published in Cancer found that cancer spread to the lymph nodes “significantly” less frequently among patients who were aspirin users. The study included 238 patients who underwent surgery for colorectal cancer, including 12% of whom were aspirin users. Researchers noted that these same patients had higher infiltration of immune cells into their tumor cells.

“These data suggested that regular aspirin use may have an active role in enhancing immunosurveillance against [colorectal cancer],” researchers noted.

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“Our study shows a complementary mechanism of cancer prevention or therapy with aspirin besides its classical drug mechanism involving inhibition of inflammation,” principal investigator Dr. Marco Scarpa of the University of Padova in Italy stated in a news release announcing the findings. “Aspirin is absorbed in the colon by passive diffusion to a significant degree. Its absorption is linear and depends on concentration along the bowel, and in the rectum, the concentration of orally administered aspirin can be much lower than in the rest of the colon. Thus, if we want to take advantage of its effects against colorectal cancer, we should think of how to guarantee that aspirin reaches the colorectal tract in adequate doses to be effective.”

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