Aspirin halves the risk of recurrence in patients with colorectal cancer, clinical trial finds

Medical Xpress / Karolinska Institutet / New England Journal of Medicine ^ | Sept. 17, 2025 | Anna Martling et al

[ConservativeMind]

A research team has shown in a new randomized clinical trial that a low dose of aspirin halves the risk of recurrence after surgery in patients with colon and rectal cancer with a certain type of genetic alteration in the tumor.

Every year, nearly two million people worldwide are diagnosed with colorectal cancer. Between 20 and 40% develop metastases.

Previous observational studies have suggested that aspirin may reduce the risk of certain cancers and possibly also the risk of recurrence after surgery in patients with colorectal cancer harboring mutations in genes within the PIK3 signaling pathway.

These genes regulate key cellular processes such as growth and division. When mutated, these processes can become dysregulated, leading to uncontrolled cell proliferation and cancer development. However, prior findings have been inconsistent and no randomized clinical trials had previously confirmed the association. To address this gap, the ALASCCA trial was initiated.

The current study included more than 3,500 patients with colon and rectal cancer from 33 hospitals in Sweden, Norway, Denmark, and Finland. Patients whose tumors showed a specific genetic mutation in the PIK3 signaling pathway—a mutation found in approximately 40% of patients—were randomized to receive either 160 mg of aspirin daily or a placebo for three years after surgery.

For patients with the genetic mutation in PIK3, the risk of recurrence was reduced by 55% in those who received aspirin compared with the placebo group.

So how does aspirin reduce the risk of recurrence of colon and rectal cancer? The researchers believe that the effect is likely due to aspirin acting through several parallel mechanisms—it reduces inflammation, inhibits platelet function and tumor growth. This combination makes the environment less favorable for cancer.

The researchers believe that the results could have global significance and influence treatment guidelines for colon and rectal cancer worldwide.

[ConservativeMind]

Aspirin helped those with “a specific genetic mutation in the PIK3 signaling pathway—a mutation found in approximately 40% of patients.” Taking 160 mg of aspirin daily reduced their recurrence by 55% over the control group with the same mutation and a placebo.

[ConservativeMind]

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[SaveFerris]

Acetylsalicylic Acid every day
if I remember

325mg X2

[chris haney]

GARBAGE

[BobL]

“325mg X2”

The study looked at double dosing Baby Aspirin (single dose is 81.25 mg). Double-dosing the adult Aspirin (single dose is 325 mg) is very much on the high side.

[SaveFerris]

I used to take 2X 500 mg

Oops 😬😬

I’m using the smaller dose from Walmart or Amazon

Maybe it’s a good thing that I forget from time-to-time 😉😜😉😉😉

Thanks!

[BobL]

Sure thing! I suspected what you meant.

[caddie]

Excellent post, Thanks.

ASA also inhibits COX and decreases colonic polyp formation, reducing the RR by a lot, maybe 30 percent according to the study.

All this plus what it does for the cardiovascular risk of a patient.

Amazing drug.

[GOPJ]

Aspirin’s cheap... I’m guessing it helps with other cancers too.