Aspirin and esophageal squamous cell carcinoma: bedside to bench

Objective To review the advances of studies on clinical results of aspirin's chemopreventive effect against esophageal squamous cell carcinoma (ESCC) and evidences for mechanisms of the antitumoural effects of aspirin in experimental research. Data sources A comprehensive search of the PubMed literatures without restriction on the publication date was carried out using keywords such as aspirin and esophageal cancer. Study selection Articles associated with aspirin and esophageal cancer are analyzed. Results This review focuses on the current evidence for use of aspirin as a chemopreventive agent in ESCC. Aspirin is the most widely used among all nonsteroidal anti-inflammatory drugs (NSAIDs), which is cheap and acceptable to patients. Several observational results provide the further investigation of prevention and therapy of aspirin or similar drugs in esophageal cancer. Data from case control studies, cohort studies and randomized controlled trials (RCTs) also give some support of a beneficial role of aspirin on ESCC. Experimental data suggest that aspirin may prevent carcinogenesis of ESCC by favorably affecting proliferation, apoptosis, or other as yet unidentified growth-regulating processes. But the mechanism by which aspirin influence on esophageal squamous cell carcinoma needs further investigation. Conclusion A wealth of evidences ranging from clinical data to experimental results are building to suggest that aspirin has significant effects in reducing both the incidence and mortality of ESCC.