Dramatic Reduction in Colorectal Cancer Recurrence Risk with a Common Over-the-Counter Medication: New Potential of Aspirin

The Swedish ALASCCA Phase III trial reported that **low-dose aspirin (160mg/day for 3 years)** significantly reduces recurrence in colorectal cancer patients with genetic alterations in the PI3K pathway. In the group with PIK3CA hotspot mutations (exon 9/20), the 3-year recurrence rate was 7.7% for aspirin and 14.1% for placebo, with a hazard ratio of 0.49 (approximately a 51% reduction). Similar effects were observed with other PI3K pathway mutations (such as PIK3R1, PTEN) with an HR of 0.42. PI3K pathway mutations were detected in about 37% of all patients. Serious adverse events occurred in 16.8% of the aspirin group and 11.6% of the placebo group, highlighting the need for safety considerations such as bleeding risk. The study was published in the September 18, 2025 issue of the 'New England Journal of Medicine'. U.S. media reported it as "halving recurrence," and discussions on social media have intensified with comments like "precision medicine with an affordable drug" and "will guidelines be revised?" In conclusion, while this could become a new option for adjuvant therapy post-surgery, its application should be narrowed down through genetic testing and considered under medical supervision.