Aspirin use may help prevent bile duct cancer

Volume 5, Issue 3, 2016

Summary

More study is needed to determine if aspirin is safe for cancer prevention.

Photograph of Lewis R. Roberts, M.B., Ch.B., Ph.D.

Lewis R. Roberts, M.B., Ch.B., Ph.D.

A team of current and former Mayo Clinic researchers has discovered that aspirin use is associated with a significantly reduced risk of developing bile duct cancer, also called cholangiocarcinoma. Results from their study were published in the April 2016 issue of Hepatology.

"Our study found that individuals who took aspirin had a more than two-and-a-half to three-and-a-half-fold lesser chance of developing bile duct cancer compared to individuals who did not take aspirin," said Lewis R. Roberts, M.B., Ch.B., Ph.D., the study's senior author and a gastroenterologist and hepatologist at Mayo Clinic in Rochester, Minnesota.

Bile duct cancer is an uncommon cancer that forms in the slender tubes (bile ducts) that carry digestive fluid through the liver. Bile duct cancer occurs mostly in people older than age 50. Symptoms include yellowing of the skin and eyes, intense itchiness of the skin, and white stools. Bile duct cancer is an aggressive type of cancer that progresses quickly and is difficult to treat.

"We know that continuous unremitting inflammation is one of the main factors that promotes cancer of the bile ducts," Dr. Roberts said. "Aspirin, with its anti-inflammatory properties, may reduce the risk of bile duct cancer by lessening inflammation through inhibition of an enzyme called cyclooxygenase (COX), which is known to promote inflammation."

In addition to the COX enzyme pathway, other studies have shown that aspirin blocks cell-signaling cascades that promote cancer development. "The evidence has been accumulating that regular, long-term use of aspirin is associated with a decreased risk of a number of different cancer types, particularly gastrointestinal cancers," Dr. Roberts said.

However, it's not certain that aspirin is safe to use for cancer prevention.

According to Dr. Roberts and his colleagues, additional confirmatory studies are needed before aspirin can be recommended for use in preventing bile duct cancer.

Future plans call for population-based studies designed to confirm the association of aspirin with decreased risk of developing bile duct cancer and clinical trials of aspirin in people at high risk of developing bile duct cancer.