Simon TG, et al. - Researchers explored the associations between aspirin dose, duration of use, and the risk of developing hepatocellular carcinoma (HCC) within two prospective, nationwide populations. The prospective cohorts of 87,507 men and 45,864 women self-reported regular use of standard dose (325 mg) aspirin tablets ≥ 2 times per week, which was identified to be associated with a significant 49% reduced risk of developing HCC. For primary prevention against HCC, use of at least 1.5 standard aspirin tablets per week seemed to be a feasible strategy; however, the investigators recommend carefully balancing potential benefits with hazards.

Methods

• In this pooled analysis of two prospective US cohort studies (the Nurses’ Health Study and the Health Professionals Follow-up Study), researchers assessed data from November 1, 2017, through March 7, 2018.
• Inclusion was performed of a total of 133,371 healthcare professionals who reported data on aspirin use, frequency, dosage, and duration of use biennially since 1980 in women and 1986 in men.
• They excluded individuals with a cancer diagnosis at baseline (except nonmelanoma skin cancer).
• Multivariable adjusted hazard ratios (HRs) and 95% CIs for HCC were calculated using Cox proportional hazards regression models.

Results

• Researchers identified documentation of 108 incident HCC cases over > 26 years of follow-up encompassing 4,232,188 person-years.
• They observed reduced HCC risk in association with regular aspirin use vs nonregular use.
• Findings suggested this benefit to be dose related: compared with nonuse, the multivariable-adjusted HR for HCC was 0.87 for up to 1.5 standard-dose tablets per week, 0.51 for > 1.5 to 5 tablets per week, and 0.49 for > 5 tablets per week (P for trend=0.006).
• With increasing duration (P for trend=0.03), they observed a significantly lower HCC risk; this decrease was apparent with use of ≥ 1.5 standard-dose aspirin tablets per week for ≥ 5 years.
• In contrast, no significant association of use of non-aspirin nonsteroidal anti-inflammatory drugs with HCC risk was observed.