In a new research presented at The Liver Meeting®, researchers have found that daily aspirin therapy significantly reduced the risk in hepatitis B virus?related liver cancer.
Hepatitis B is a viral infection that attacks the liver. HBV can be contracted through contact with an infected person's blood or other bodily fluid, and the infection can either be acute or chronic. Death from HBV is commonly due to the development of cirrhosis (scarring of healthy liver tissue) or hepatocellular carcinoma (liver cancer).
The previous study suggested that daily aspirin therapy (often prescribed to prevent cardiovascular disease) may also prevent the development of cancer. However, there is lack of clinical evidence for the effectiveness of aspirin therapy in preventing HBV?related liver cancer.Researchers conducted a nationwide cohort study to determine if aspirin therapy could, indeed, reduce liver cancer risk.
Liver cancer is the second leading cause of cancer death worldwide, and HBV is the most prevalent risk factor. The lead investigator of the study Dr Teng?Yu Lee said although current antiviral medicines such as nucleos(t)ide analogue therapy could significantly reduce liver cancer risk, most HBV carriers are not indicated for antiviral therapy, so another effective way of reducing liver cancer risk needs to be developed.
Aspirin has been investigated to explore its chemopreventive effect in cancers that are related to chronic inflammation, particularly in the prevention of colorectal cancer. However, clinical evidence supporting the chemopreventive effect of aspirin therapy on liver cancer remains limited. Hence, the team conducted a large?scale cohort study to evaluate the association of aspirin therapy with HBV?related liver cancer.
The researchers retrieved medical records from the National Health Insurance Research Database for their study. The researchers screened records of 204,507 patients with chronic hepatitis B and excluded patients with other forms of infectious hepatitis. After excluding patients with liver cancer before the follow?up index dates, patients who had continuously received daily aspirin were randomly matched with patients who had never received anti-platelet therapy.
The researchers analyzed both cumulative incidents of and hazard ratios for HCC development after adjusting for competing for mortality. Cumulative incidence of liver cancer in the group treated with aspirin therapy was significantly lower than that in the untreated group in five years.In the multivariate regression analysis, the researchers found aspirin therapy was independently associated with reduced liver cancer risk.
Sensitivity subgroup analyses also verified this association. Older age, male gender, cirrhosis and diabetes also were independently associated with an increased risk, but nucleos(t)ide analogue or statin use was associated with a decreased risk.
For effectively preventing HBV?related liver cancer, the findings of the study might help hepatologists treat patients with chronic HBV infection in the future, particularly for those who are not indicated for antiviral therapy. We are pursuing prospective investigations for further confirming the findings, Dr Lee concluded.