Martling’s study, published in September 2025, quickly changed practice in Sweden. Since January 2026, bowel cancer patients in the country have started being screened for the mutations in question, and offered a low dose of aspirin if they have them.
It is not yet clear whether aspirin could protect patients from other cancers as well – but we may soon have some answers. Langley is currently running a large randomized controlled trial with 11,000 participants who’ve had colorectal, breast, gastroesophageal, or prostate cancer in the UK, Ireland and India. Her team will be looking at the effect of a daily 100mg or 300mg preventative dose of aspirin, and they’re hoping to have results next year.
“We really are the first to explore the role of aspirin in other tumor types,” she says. She is aiming to replicate Martling’s findings for colorectal cancer, as well as gathering funds to investigate the implications of the specific mutations in the other cancers, too. The replication is key, she says, as authorities ideally want two sets of trial results before they make recommendations for patients.
How does it work?
The precise mechanism by which aspirin prevents cancer has long remained a mystery. “This fantastic drug works both within the cell and outside the cell,” explains Martling, so there could be several different mechanisms involved. Her own works implicates an enzyme within the cell called Cox-2, which we know is inhibited by aspirin. This enzyme helps produce hormone-like compounds called prostaglandins, she says, which in turn activates a signalling pathway that can lead to uncontrolled cell growth.
Recent research by Rahul Roychoudhuri, a professor of cancer immunology at the University of Cambridge in the UK, and his colleagues, suggests there may be another mechanism involving a gene that inhibits T-cells in the immune system from spotting and killing metastatic cancer cells.
They found that this gene can be activated by a clotting factor called thromboxane A2, which – as the name suggests – helps the blood to form clots when we have been injured. Since aspirin inhibits thromboxane, it may therefore render cancerous cells more visible to the immune system. This came as a surprise to the team.
Some countries already recommend a regular dose of aspirin for those with a high risk of cancer
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