P1794 - Does Aspirin Reduce the Incidence of Hepatocellular Carcinoma? A Meta-Analysis

Shaodi Ma, ¹, Chenyu Sun, MD, MSc², Yue Chen, ³, Yuemeng Jiang, ⁴, John Pocholo W. Tuason, MD², Nikitha Manem, MD², Chandur Bhan, MD², Na Hyun Kim, MD², Humaed Mohammed Abdul, MD^2
1School of Public Health, Anhui Medical University, Hefei, Anhui, China; ²AMITA Health Saint Joseph Hospital, Chicago, IL; ³School of the First Clinical Medicine, Anhui Medical University, Hefei, Anhui, China; ⁴The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

Introduction: Liver cancer is the sixth most prevalent cancer globally (excluding nonmelanoma skin cancer), with over 905,000 new cases reported in 2020. Hepatocellular carcinoma (HCC) is the most common form of liver cancer. According to the Global Cancer Statistics of 2020, the yearly burden of HCC is estimated to be 905,677 new cases, resulting in 830,180 deaths. Given this fairly high incidence, it is critical to identify effective interventions or programs that can prevent or indeed reduce the onset and progression of the disease. Aspirin, one of the most ubiquitously consumed drugs worldwide, has proven benefits in the context of cardiovascular disease and some cancers. However, an 11-year-long randomized control trial (RCT) of 39,876 US women, reported no beneficial effects associated with aspirin use and all forms of cancer. Thus, we used the approach of meta-analysis to summarize all eligible epidemiological evidence for an association between aspirin use and the incident risk of HCC.

Methods: The literature searching was completed before May 17, 2021, for relevant available articles from the following databases: (1) PubMed; (2) Embase; (3) Cochrane library; (4) Web of Science. Statistical analyses of all data were performed with Stata (version 14.0; Stata Corp, College Station, TX) and RevMan (version 5.3; Cochrane library) software. Hazard ratios (HRs) with 95% confidence intervals (CI) were pooled through random-effect, depending on the heterogeneity which was evaluated through the Q test and I-squared statistic. Sensitivity analysis and publication bias assessment were also conducted.

Results: Fifteen studies were included. This meta-analysis indicates that aspirin reduces the overall risk of incidence of HCC (pooled HR = 0.61, 95% CI = 0.50-0.74, I² =90%). No publication bias was detected based on Begg's test and Egger's test (P-value of Begg's test was 0.067, and P-value of Egger's test was 0.926). Funnel plot was shown to be symmetrical. Sensitivity analysis suggested the results were relatively stable.

Discussion: Overall, aspirin is associated with a reduced risk of HCC for all populations. However, further analysis based on different type (source) populations. The emerging evidence on aspirin s cancer protection role highlights an exciting time for cancer prevention through low-cost interventions.


Figure: PRISMA flow diagram (A),forest plot (B) and funnel plot (C).


Disclosures:
Shaodi Ma indicated no relevant financial relationships.
Chenyu Sun indicated no relevant financial relationships.
Yue Chen indicated no relevant financial relationships.
Yuemeng Jiang indicated no relevant financial relationships.
John Pocholo Tuason indicated no relevant financial relationships.
Nikitha Manem indicated no relevant financial relationships.
Chandur Bhan indicated no relevant financial relationships.
Na Hyun Kim indicated no relevant financial relationships.
Humaed Mohammed Abdul indicated no relevant financial relationships.


Shaodi Ma, ¹, Chenyu Sun, MD, MSc², Yue Chen, ³, Yuemeng Jiang, ⁴, John Pocholo W. Tuason, MD², Nikitha Manem, MD², Chandur Bhan, MD², Na Hyun Kim, MD², Humaed Mohammed Abdul, MD². P1794 - Does Aspirin Reduce the Incidence of Hepatocellular Carcinoma? A Meta-Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.