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New research from Sweden suggests that a daily low-dose aspirin regimen may significantly reduce the risk of colorectal cancer recurrence for certain patients following surgery. The findings, published in the New England Journal of Medicine, are the result of the Alascca trial, which involved over 3,500 colorectal cancer patients from Sweden, Norway, Denmark, and Finland.
Led by Professor Anna Martling at the Karolinska Institute, the study focused on patients with specific genetic mutations in the PI3K pathway, which is linked to colorectal cancer. Of the 2,980 participants analyzed for genetic markers, about 1,103—approximately 37 percent—had these mutations. These patients were randomly assigned to receive either 160 milligrams of aspirin daily or a placebo for three years after their surgery.
The results showed a remarkable 55 percent reduction in the risk of cancer recurrence among those who took aspirin. This significant finding points to the potential of aspirin as a preventive measure for patients with the identified genetic mutation, marking a potential shift in clinical practices regarding post-surgical care for colorectal cancer patients.
As research into aspirin’s effects continues, its mechanism in cancer prevention appears to involve suppression of inflammation, disruption of the PI3K pathway, and a reduction in blood platelet activity, which can help the immune system target tumor cells more effectively. While previous studies indicated aspirin’s protective benefits for individuals with hereditary conditions like Lynch syndrome, its role in preventing recurrence after tumor removal had not been conclusively established until this trial.
The study also highlights the importance of genetic testing for colorectal cancer patients, as identifying those with PI3K mutations may help healthcare providers offer tailored post-surgical treatments. Despite its low cost and widespread availability, the use of aspirin is not without risks. Some trial participants experienced severe side effects, including gastrointestinal bleeding and allergic reactions, underscoring the necessity for careful consideration and consultation with healthcare professionals before beginning long-term aspirin use.
This research contributes to a growing body of evidence supporting the strategic use of low-dose aspirin as a tool in cancer prevention, particularly for specific patient groups. Further large-scale studies are anticipated to refine who might benefit most from such treatments, advancing personalized cancer care.
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