Aspirin Use and the Risk of Hepatocellular Carcinoma: A Meta-analysis

Liao, Kuan‐Fu; Lai, Shih‐Wei

doi:10.1097/mcg.0000000000001856

Cited by 1 publication

(2 citation statements)

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“…Multiple meta-analyses [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] have been published over the last few years, summarising the observational data in this area, with the majority of these concluding that aspirin does have a significant association with a reduced HCC risk. Unfortunately, the majority of these systematic reviews have introduced bias into their risk estimates via the erroneous inclusion of multiple studies drawing from the same population.…”

Section: Discussionmentioning

confidence: 99%

“…The results have varied; however, recently, a number of large high-quality studies have suggested that there is a duration-dependent effect of aspirin in reducing the incidence of HCC, supporting a causal relationship. A number of meta-analyses have been published [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]; however, many of these have erroneously included multiple studies drawing from the same population registries, calling into question the validity of their results. In this systematic review and meta-analysis, we aimed to pool all the available observational data, and perform an accurate meta-analysis, to provide an updated assessment of the relationship between aspirin use and the risk of incident HCC.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Aspirin Use on Incident Hepatocellular Carcinoma—An Updated Systematic Review and Meta-Analysis

Abdelmalak

Tan

Con

et al. 2023

Cancers

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An increasing number of observational studies have described an association between aspirin use and a reduced risk of incident hepatocellular carcinoma. We performed this meta-analysis to provide a comprehensive and updated aggregate assessment of the effect of aspirin on HCC incidence. Two independent authors performed a systematic search of the literature, utilising the Medline, Embase, Scopus, and PubMed databases. A total of 16 studies (12 cohort studies, and 4 case-control studies) were selected for inclusion, with a large number of studies excluded, due to an overlapping study population. The pooled analysis of cohort studies involving a total population of approximately 2.5 million subjects, 822,680 aspirin users, and 20,626 HCC cases demonstrated a 30% reduced risk of HCC associated with aspirin use (adjusted HR 0.70, 95%CI 0.60–0.81). There was a similar but non-significant association observed across the case-control studies (adjusted OR 0.60, 95%CI 0.32–1.15, p = 0.13), which involved a total of 1961 HCC cases. In a subgroup meta-analysis of patients with cirrhosis, the relationship between aspirin use and incident HCC diminished to non-significance (adjusted HR 0.96, 95%CI 0.84–1.09). Aspirin use was associated with a statistically significant increase in bleeding events when all relevant studies were pooled together (adjusted HR 1.11, 95%CI 1.02–1.22). Prospectively collected data should be sought, to define the optimal patient group in which aspirin is safe and effective for the chemoprophylaxis of HCC.

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