Daily aspirin may reduce risk of hepatitis-related liver cancer

A Taiwanese nationwide cohort study of more than 10,000 patients with chronic hepatitis B showed a statistically significant 29% risk reduction for hepatocellular carcinoma in patients who received daily aspirin compared with matched controls.


Daily aspirin may be associated with a reduced risk of hepatocellular carcinoma (HCC) related to the hepatitis B virus (HBV), a study found.

Researchers in Taiwan screened a nationwide cohort of 204,507 patients with chronic hepatitis B from January 1997 to December 2012. In a 1:4 ratio, they randomly matched 2,123 patients who took daily aspirin for 90 or more days (treated group) with 8,492 patients who had never received aspirin (untreated group). The study results were published March 18 by JAMA Internal Medicine.

At five years, the cumulative incidence of HCC was significantly lower in the treated group than in the untreated group (5.20% [95% CI, 4.11% to 6.29%] vs. 7.87% [95% CI, 7.15% to 8.60%]; P<0.001). In a multivariable regression analysis, aspirin therapy was independently associated with a reduced risk for HCC (hazard ratio [HR], 0.71; 95% CI, 0.58 to 0.86; P<0.001). The association was verified in sensitivity subgroup analyses, where all HRs were less than 1.0.

Older age (HR, 1.01 per year; 95% CI, 1.00 to 1.02), male sex (HR, 1.75; 95% CI, 1.43 to 2.14), and cirrhosis (HR, 2.89; 95% CI, 2.45 to 3.40) were independently associated with increased HCC risk. Use of a nucleos(t)ide analogue (NA) or statin was associated with a decreased HCC risk (HRs, 0.54 [95% CI, 0.41 to 0.71] and 0.62 [95% CI, 0.42 to 0.90], respectively).

Limitations of the study included its observational design, its inclusion of solely middle-aged and older patients, and its lack of detailed laboratory data, among others, the authors stated. The results indicate that daily aspirin therapy may help improve the chemoprevention of HBV-related HCC, they noted.

“In the present study, we report that daily aspirin therapy was associated with a reduced incidence of HCC in patients with CHB [chronic hepatitis B],” the authors wrote. “In patients who did not receive NA therapy, aspirin therapy was also independently associated with a decreased HCC risk. Our findings may be of help in future efforts to further improve the chemoprevention of HBV-related HCC, and a proof-of-concept study is thus warranted.”