Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose–response meta-analysis

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

“…One meta-analysis conducted by Wang et al 1 reported that aspirin use was less likely to develop hepatocellular carcinoma than nonuse (odds ratio=0.54, 95% CI=0.44 to 0.66). This result is compatible with 2 previous meta-analyses showing a significant risk reduction of hepatocellular carcinoma among aspirin users as compared with nonaspirin users (hazard ratio ranging from 0.56 to 0.75) 2,3 . Some points are discussed.…”

“…More randomized, doubleblind, controlled trials with enough sample sizes and validated research protocols are required to evaluate the benefits and the risks of aspirin use in the chemoprevention of hepatocellular carcinoma. 3 Kuan-Fu Liao, MD, PHD* † Shih-Wei Lai, MD ‡ §∥…”

“…Fourth, currently, aspirin use for chemoprevention of hepatocellular carcinoma should not be overemphasized because there have been no randomized controlled trials for aspirin use where the primary endpoint was set as the development of hepatocellular carcinoma. More randomized, double-blind, controlled trials with enough sample sizes and validated research protocols are required to evaluate the benefits and the risks of aspirin use in the chemoprevention of hepatocellular carcinoma 3 …”

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

“…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.…”

“…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.…”