Study paves way for tailored bowel cancer prevention with aspirin
“The findings of this study are interesting but we’re still some way off from being able to tell who might benefit from using aspirin” - Dr David Adams, Cancer Research UK
Previous studies have shown that taking aspirin daily could help prevent the disease, but the drug’s side effects have caused concern over prescribing it widely, as has uncertainty over the optimum dose.
Now a team of researchers, including experts from Case Western Reserve University School of Medicine, the Dana Farber Cancer Institute, Harvard University, Massachusetts General Hospital, and University Hospitals Case Medical Center, have found a molecule in the bowel lining whose levels could identify those people who may benefit.
The results also suggest the mechanism by which the drug exerts its protective effect - something that has remained elusive despite years of research.
The latest study looked at data from two long-term studies involving nearly 128,000 participants, including 270 people who developed bowel cancer, many of whom had taken aspirin.
They found those with high levels of a molecule called 15-PGDH in the lining of their bowel had lower chances of developing bowel cancer if they took a regular dose of aspirin.
The beneficial effects of aspirin were not seen in people with low levels of 15-PGDH.
Senior author Professor Sanford Markowitz, from Case Western Reserve School of Medicine, said: "If you looked at the folks from the study who had high 15-PGDH levels and took aspirin, they cut their risk of colon cancer by half.
"If you looked at the folks from the study that were low for 15-PGDH, they did not benefit at all from taking aspirin.” The findings, he said, represented “a clean Yes-No” about who could benefit from regular aspirin.
The new research opens up the possibility of developing tests for measuring 15-PGDH in the bowel lining. Such tests would help doctors decide which patients would most benefit from treatments that include aspirin or other drugs that work in a similar manner.
However as Dr David Adams - a Cancer Research UK expert in bowel cancer genetics - commented, such a test is still some way off routine use.
“The findings of this study are interesting but as the authors state, we still don’t have an easy way of measuring levels of the marker 15-PGDH, so we’re still some way off from being able to tell who might benefit from using aspirin to reduce their risk from bowel cancer,” he said.
Dr Adams also pointed out that aspirin was not the only way to reduce bowel cancer risk. “In terms of lowering your risk of bowel cancer it’s important to eat a balanced diet, limiting the amount of red and processed meat and boosting the amount of fibre,” he added.
The study is published in the journal Science Translational Medicine, and was funded by the US National Institutes of Health, along with several other US research foundations.
Copyright Press Association 2014
- Fink S.P, et al. (2014). Aspirin and the Risk of Colorectal Cancer in Relation to the Expression of 15-Hydroxyprostaglandin Dehydrogenase (HPGD), Science Translational Medicine, 6 (233) 233re2-233re2. DOI: 10.1126/scitranslmed.3008481