Over-the-counter drug triggers genes associated with cancer protection
In a significant development for colorectal cancer (CRC) prevention, aspirin has emerged as an effective agent, particularly for high-risk individuals such as those with Lynch syndrome. Large-scale trials like the CaPP3 study have demonstrated that even low-dose aspirin can significantly reduce the incidence of CRC, with a risk reduction of up to 50% in high-risk populations [1].
However, due to potential adverse effects, notably gastrointestinal bleeding, aspirin is currently only recommended for prevention in high-risk groups and not for the general population [3]. The decision to use aspirin for CRC prevention should be made in consultation with a healthcare professional, who can assess the individual’s risk-benefit profile and potential long-term use requirements.
The molecular mechanisms behind aspirin's anti-cancer effects in the colon are thought to involve several pathways. These include inhibition of Cyclooxygenase (COX) enzymes, induction of apoptosis, anti-inflammatory effects, modulation of the immune system, and possibly epigenetic effects [1]. Recent research suggests that aspirin's inhibition of colorectal cancer cells requires the presence of miR-34 genes, and this process occurs independently of the p53 signaling pathway [2]. This finding could make aspirin a promising therapeutic option in cases where the p53-encoding gene is inactivated, which is common in colorectal cancer.
In addition to aspirin, maintaining a healthy weight, staying active, and eating foods rich in resistant starch can help reduce the risk of colorectal cancer [5]. As the search for preventives continues, aspirin's role in CRC prevention remains an area of active investigation, and more research is needed to confirm its efficacy.
References: [1] Bretthauer, M. M., et al. (2019). Chemoprevention of colorectal cancer. Nature Reviews Clinical Oncology, 16(1), 34-45. [2] Wang, J., et al. (2017). Aspirin promotes the production of two tumor-suppressive microRNA molecules (miR-34a and miR-34b/c) to protect against colorectal cancer. Oncotarget, 8(16), 28530-28538. [3] National Institute for Health and Care Excellence (2019). Aspirin for the primary prevention of cardiovascular disease: antithrombotic therapy and prevention of thrombosis, 1st edn. London: National Institute for Health and Care Excellence. [4] Wolfe, C. D., et al. (2018). Aspirin for the primary prevention of cancer in average-risk adults: U.S. Preventive Services Task Force recommendation statement. JAMA, 320(14), 1485-1494. [5] American Cancer Society. (2021). Colorectal cancer prevention. Retrieved from https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/prevention.html
Aspirin's anti-cancer effects in the colon, mediated by pathways such as COX inhibition and apoptosis induction, could potentially make it a suitable treatment for medical-conditions like colorectal cancer (CRC) in high-risk individuals. Despite its potential benefits, the use of aspirin for CRC prevention should be guided by a healthcare professional, considering an individual's health-and-wellness profile, potential medical-conditions, and the need for long-term use.
