Can Aspirin Reduce the Risk of HCC in Cirrhosis: The AspiRe HCC Trial

This clinical trial is testing whether taking a low dose aspirin tablet (100 mg) once a day can help prevent liver cancer (hepatocellular carcinoma, HCC) in people who have cirrhosis, which is severe scarring of the liver. People with cirrhosis have a higher risk of developing HCC. Currently, there is no approved treatment that prevents liver cancer in this group. Research from around the world suggests that low dose aspirin might reduce the risk of liver cancer by up to half and is safe for people with cirrhosis. However, it is not yet approved for this purpose in Australia. A trial is needed to find out if aspirin really can prevent liver cancer in people with cirrhosis and is safe for these people to use. 890 people from up to 7 hospitals across Australia will take part. Participants will take medication daily for 4 years. They will be randomly allocated to either aspirin or a placebo (dummy pill). Participants will continue to have their regular 6 monthly clinic visit with liver ultrasounds and blood tests as part of their normal care. If at any time liver cancer is found, they will stop the trial. Participants will also complete some extra tasks: * Record missed doses or other medications in a small diary. * Fill in two short quality of life surveys each year. * Return their medication and diary at their regular 6 monthly appointments. * In Western Australia only: they will be invited to give optional blood samples for future research.