Aspirin appears useful in preventing Hodgkin’s disease and esophageal cancer

Regular aspirin use may be an effective way to prevent Hodgkin’s disease and esophageal adenocarcinoma, according to findings from two studies reported in the Journal of the National Cancer Institute for February 18.

In one study, Dr. Ellen T. Chang, from the Harvard School of Public Health in Boston, and colleagues assessed the link between analgesic use and Hodgkin’s disease by analyzing data from 565 patients with Hodgkin’s disease and 679 matched control subjects. Regular analgesic use was defined as taking at least 2 tablets per week for the preceding 5 years. Regular aspirin users were 40% less likely to have Hodgkin’s disease than non-regular users, the researchers found. In contrast, regular use of other NSAIDs had no effect on the risk of this malignancy.The investigators did find an elevated risk of Hodgkin’s disease for regular users of acetaminophen. However, based on previous reports, which have never linked the drug to this cancer, they believe the increased risk is “more likely explained by uncontrolled confounding by other factors than by a true association.”The finding that aspirin, but not other NSAIDs, has an effect on the risk of Hodgkin’s disease, suggests that aspirin is working through non-cyclooxygenase pathways, Dr. Chang’s team surmises. Combined with previous research, the current results suggest that inhibition of transcription factor nuclear factor kappa-B may be involved. In the second study, Dr. Chin Hur and colleagues, from Massachusetts General Hospital in Boston, looked at the cost-effectiveness of aspirin use for preventing Barrett’s esophagus from progressing to adenocarcinoma.While recent indicate that NSAIDs including aspirin may be effective for this indication, “use of aspirin is associated with numerous potential complications,” the team notes.Using a decision model, they found that daily use of 325-mg enteric-coated aspirin was more effective and less costly than no therapy in preventing progression to cancer. Moreover, this advantage remained regardless of whether aspirin therapy was combined with endoscopic surveillance. The results suggest that even if taken solely as a means to prevent esophageal cancer, aspirin therapy is cost effective, the authors state. “In a patient who has Barrett’s esophagus and concomitant cardiac risk factors, aspirin use for primary prevention may be an obvious recommendation.”(Source: J Natl Cancer Inst 2004;96:305-315,316-325: Reuters Health: February 19, 2004: Oncolink)