Kontroversi Penggunaan Aspirin untuk Pencegahan Kanker

Oleh :

dr. Qorry Amanda, M.Biomed

Berbagai penelitian telah mengevaluasi manfaat penggunaan aspirin dalam pencegahan kanker, tetapi hasilnya masih saling bertentangan. Aspirin merupakan obat antiinflamasi nonsteroid yang umum digunakan dalam penanganan kasus kardiovaskular. Beberapa studi observasional menunjukkan bahwa aspirin dosis rendah jangka panjang dapat mengurangi risiko kejadian kanker, terutama kanker kolorektal dan kanker gastrointestinal lain.

Kanker merupakan penyebab kematian terbanyak kedua di seluruh dunia. Telah diperkirakan ada sekitar 9,6 juta kematian terkait kanker per tahun secara global. Aspirin diduga mampu mencegah kanker melalui mekanisme inhibisi siklooksigenase-2 (COX-2), pengurangan inflamasi kronis, serta modulasi jalur molekuler terkait apoptosis dan angiogenesis.[1,2]

Sumber: 14 Mostafa&zeyad, Wikimedia commons, 2014.

Teori Mekanisme Aspirin dalam Pencegahan Kanker

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Lloyd KE, Hall LH, King N, et al; AsCaP Group. Aspirin use for cancer prevention: A systematic review of public, patient and healthcare provider attitudes and adherence behaviours. Prev Med. 2022 Jan;154:106872. doi: 10.1016/j.ypmed.2021.106872.
2. Miret Durazo CI, Zachariah Saji S, Rawat A, et al. Exploring Aspirin's Potential in Cancer Prevention: A Comprehensive Review of the Current Evidence. Cureus. 2024 Sep 23;16(9):e70005. doi: 10.7759/cureus.70005.
3. Ornelas A, Zacharias-Millward N, Menter DG, et al. Beyond COX-1: the effects of aspirin on platelet biology and potential mechanisms of chemoprevention. Cancer Metastasis Rev. 2017 Jun;36(2):289-303. doi: 10.1007/s10555-017-9675-z
4. Zumwalt TJ, Wodarz D, Komarova NL, et al. Aspirin-Induced Chemoprevention and Response Kinetics Are Enhanced by PIK3CA Mutations in Colorectal Cancer Cells. Cancer Prev Res (Phila). 2017 Mar;10(3):208-218. doi: 10.1158/1940-6207.CAPR-16-0175.
5. Zhang Y, Lv C, Dong Y, Yang Q. Aspirin-targeted PD-L1 in lung cancer growth inhibition. Thorac Cancer. 2020 Jun;11(6):1587-1593. doi: 10.1111/1759-7714.13433.
6. Sulciner ML, Serhan CN, Gilligan MM, et al. Resolvins suppress tumor growth and enhance cancer therapy. J Exp Med. 2018 Jan 2;215(1):115-140. doi: 10.1084/jem.20170681.
7. Gilligan MM, Gartung A, Sulciner ML, et al. Aspirin-triggered proresolving mediators stimulate resolution in cancer. Proc Natl Acad Sci U S A. 2019 Mar 26;116(13):6292-6297. doi: 10.1073/pnas.1804000116
8. Serhan CN. Pro-resolving lipid mediators are leads for resolution physiology. Nature. 2014 Jun 5;510(7503):92-101. doi: 10.1038/nature13479.
9. Nan H, Hutter CM, Lin Y, et al. Association of aspirin and NSAID use with risk of colorectal cancer according to genetic variants. JAMA. 2015 Mar 17;313(11):1133-42. doi: 10.1001/jama.2015.1815.
10. Simon TG, Duberg AS, Aleman S, et al. Association of Aspirin with Hepatocellular Carcinoma and Liver-Related Mortality. N Engl J Med. 2020 Mar 12;382(11):1018-1028. doi: 10.1056/NEJMoa1912035
11. Skriver C, Maltesen T, Dehlendorff C, Skovlund CW, Schmidt M, Sørensen HT, Friis S. Long-term aspirin use and cancer risk: a 20-year cohort study. J Natl Cancer Inst. 2024 Apr 5;116(4):530-538. doi: 10.1093/jnci/djad231.
12. Florensa D, Mateo J, Solsona F, et al. Low-dose acetylsalicylic acid for cancer prevention considering risk factors: a retrospective cohort study. Ann Epidemiol. 2023 Aug;84:60-66. doi: 10.1016/j.annepidem.2023.06.002
13. Elwood P, Morgan G, Watkins J, et al. Aspirin and cancer treatment: systematic reviews and meta-analyses of evidence: for and against. Br J Cancer, 2024. 130:3–8. https://doi.org/10.1038/s41416-023-02506-5
14. Wu Q, Yao X, Chen H, et al. Long-term aspirin use for primary cancer prevention: An updated systematic review and subgroup meta-analysis of 29 randomized clinical trials. J Cancer. 2020 Sep 14;11(21):6460-6473. doi: 10.7150/jca.49001.
15. McNeil JJ, Nelson MR, Woods RL, et al; ASPREE Investigator Group. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. N Engl J Med. 2018 Oct 18;379(16):1519-1528. doi: 10.1056/NEJMoa1803955
16. Huang ES, Strate LL, Ho WW, Lee SS, Chan AT. Long-term use of aspirin and the risk of gastrointestinal bleeding. Am J Med. 2011;124(5):426-433. doi:10.1016/j.amjmed.2010.12.022
17. McNeil JJ, Gibbs P, Orchard SG, et al; ASPREE Investigator Group. Effect of Aspirin on Cancer Incidence and Mortality in Older Adults. J Natl Cancer Inst. 2021 Mar 1;113(3):258-265. doi: 10.1093/jnci/djaa114.
18. Wang L, Zhang R, Yu L, et al. Aspirin Use and Common Cancer Risk: A Meta-Analysis of Cohort Studies and Randomized Controlled Trials. Front Oncol. 2021 Jun 18;11:690219. doi: 10.3389/fonc.2021.690219.
19. US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement. JAMA. 2022 Apr 26;327(16):1577-1584. doi: 10.1001/jama.2022.4983.