Daily aspirin consumption may a reduce the risk of hepatocellular carcinoma (HCC) in patients with hepatitis B virus, according to a study published in JAMA Internal Medicine.
This Taiwan nationwide cohort study screened 204,507 patients with chronic hepatitis B between January 1, 1997, and December 31, 2012. Researchers excluded patients with confounding conditions.
The final cohort included 2,123 patients who continuously received daily aspirin for 90 or more days (treated group) who were randomly matched 1:4 with 8,492 patients who had never received antiplatelet therapy (untreated group). Among the total cohort (n=10,615), 72.4% (n=7,690) were male, and the mean patient age was 58.8 years.
Aspirin Reduces Risk of Liver Cancer
The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group at five years (5.20% [95% CI, 4.11-6.29] vs. 7.87% [95% CI, 7.15-8.60]; P<0.001), representing a 29% reduction of risk.
Per multivariable regression analysis, aspirin consumption was independently associated with a reduced risk of HCC (hazard ratio [HR] = 0.71; 95% CI, 0.58-0.86; P<0.001).
— Raymond DuBois (@Rndubois) March 19, 2019
Other Factors Associated With HCC Risk
Factors independently associated with an increased risk of HCC included:
- Older age (HR=1.01 per year; 95% CI, 1.00-1.02)
- Male sex (HR=1.75; 95% CI, 1.43-2.14)
- Cirrhosis (HR=2.89; 95% CI, 2.45-3.40)
However, nucleos(t)ide analogue (HR=0.54; 95% CI, 0.41-0.71) and statin (HR=0.62; 95% CI, 0.42-0.90) use were associated with a decreased risk of HCC.
This study on ASA & HCC risk was provocative enough that I needed an expert to contextualize the results. @JAMAInternalMed and @renafoxmd outdid themselves with an excellent & practical commentary that helps frame the study for readers. https://t.co/bPJIJsMTCp
— Michael Incze, MD (@MInczeMD) March 18, 2019