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Daily low-dose aspirin lowers bowel cancer risk in people with Lynch syndrome and appears to cut recurrence in bowel cancers with a particular mutation. In healthy older people it caused more harm than good.
Long-term aspirin reduces colorectal cancer incidence and mortality in pooled analyses of cardiovascular trials with 20-year follow-up, and in CAPP2 halved colorectal cancer in Lynch syndrome carriers (600 mg/day, 10-year follow-up); the US Preventive Services Task Force nonetheless withdrew its general recommendation in 2022 because ASPREE (NEJM 2018) found more cancer deaths (HR 1.31) and no cancer prevention in healthy adults aged 70 and over. In the adjuvant setting the biomarker-directed ALASCCA trial (NEJM 2025) showed that 160 mg aspirin for three years roughly halved recurrence in resected colorectal cancer with PIK3CA or other PI3K-pathway alterations, and the 11,000-patient ADD-ASPIRIN trial across breast, colorectal, gastro-oesophageal and prostate cancers continues. Aspirin is the model repurposed generic: cheap, mechanistically plausible, and requiring publicly funded trials because no company will run them.
COX-1/COX-2 inhibition reduces prostaglandin E2-driven proliferation and inflammation and blunts platelet cloaking of circulating tumour cells; PI3K-pathway-mutant tumours depend on PTGS2 signalling and are selectively sensitive.
One trial page and one technology page on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
This paper is the molecular sequel to the 2002 inflammation and cancer review and the basis for IL-6, JAK-STAT and NF-kB directed strategies in cancer as well as for aspirin and other anti-inflammatory prevention trials.
Together with the 2002 Nature review this essay put inflammation on the cancer research agenda; the tumour-associated macrophage and IL-6 work that followed, and the aspirin prevention trials, trace back to it.
Query for this technology: (TITLE:"Aspirin for cancer prevention and adjuvant therapy" OR ABSTRACT:"Aspirin for cancer prevention and adjuvant therapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Aspirin for cancer prevention and adjuvant therapy, not a curated reading list.
Shares CAPP2, Get every Lynch syndrome carrier onto the right dose of aspirin, Get biomarker-directed aspirin after colorectal surgery into labels and guidelines, Lynch syndrome.
Shares Balkwill and Mantovani 2001: inflammation and cancer, back to Virchow?, Grivennikov, Greten and Karin 2010: immunity, inflammation and cancer, Inflammation, Microenvironment and inflammation: tumours as wounds that do not heal.
Shares Grivennikov, Greten and Karin 2010: immunity, inflammation and cancer, Inflammation, Microenvironment and inflammation: tumours as wounds that do not heal, Chemoprevention & risk-reducing surgery.
Shares CAPP2, ASPREE (ASPirin in Reducing Events in the Elderly), ALASCCA, Add-Aspirin.
Shares Intravasation & circulating tumour cells, Lynch syndrome, Mismatch repair & microsatellite instability, Gastric & gastro-oesophageal junction cancer.
Shares Chemoprevention & risk-reducing surgery, Germline vs somatic mutations, Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers, HR-positive / HER2-negative breast cancer.
Shares CAPP2, Lynch syndrome, Colorectal cancer.
Shares No incentive to repurpose cheap drugs, PI3K / AKT / mTOR, Funding follows fashion, not burden, HR-positive / HER2-negative breast cancer.