JAMA Netw Open: Evaluation of aspirin use and cancer incidence and survival rates in older patients

For people aged 50 to 59 at high risk of cardiovascular disease, the guidelines recommend aspirin as a first-stage prevention of cardiovascular disease, while also reducing the risk of colorectal cancer.
, however, for people aged 60 to 69, the recommendations are based on an individualized risk-benefit analysis, with limited data for people under 50 or over 70.
despite the potential risks, 25 to 50 percent of U.S. adults report taking aspirin daily or every other day, with increased use as they age.
long-term aspirin use was associated with reduced mortality from heart disease, stroke, cancer (especially gastrointestinal cancer) and all-cause mortality.
considering that aspirin non-selectively inhibits epoxygenase, thereby suppressing inflammation, long-term use of aspirin may affect the occurrence of cancer.
recent large-scale assessments have shown that immune cell activity abnormalities in several tumor types, including bladder, breast, stomach and uterine tumors, provide the primary target for aspirin activity.
, aspirin use has been shown to affect survival rates after cancer diagnosis, although the data are still different.
researchers studied the correlation between aspirin and cancer risk and tumor site-specific survival rates in patients with bladder, breast, esophageal, stomach, pancreatic and uterine cancers.
the findings were published in jama Netw Open.
the cohort study used data from screening trials for prostate, lung, colorectal and ovarian cancers.
subjects had a baseline age of 65 years or older (1993-2001) and follow-up age was 65 years.
data analysis was conducted from January to June 2020.
outcome is to study the incidence and survival rates of cancer types.
single variable and multivariate risk ratio (HRs) and 95% confidence interval using the Cox proportional risk regression model, and adjust the covariates.
multivariable model of the incidence includes time-variable covariation variables.
the study, a total of 139,896 people were included in the analysis (average age at baseline, 66.4 years, 2.4 years; 71884 (51.4 per cent) women; 123824 (88.5 per cent) of non-Hispanic whites).
the study period, 32,580 cases of cancer (1,751 cases of bladder cancer, 4,552 cases of breast cancer, 332 cases) were reported. 1.0% of esophageal cancer, 397 cases of stomach cancer, 878 cases of pancreatic cancer and 716 cases of uterine cancer.
in people 65 years of age or older, aspirin use was independent of the incidence of any type of cancer studied.
multivariate regression analysis showed that aspirin and bladder cancer (HR, 0.67; 95% CI, 0.51-0.88) and breast cancer (HR, 0.88) were taken at least three times a week HR, 0.75;95%CI, 0.59-0.96) was associated with an increase in survival rates in patients with esophageal, stomach, pancreatic, or uterine cancer.
use of aspirin has a similar relationship with bladder cancer (HR, 0.75; 95% CI, 0.58-0.98) and breast cancer (HR, 0.79; 95% CI, 0.63-0.99).
The use of aspirin in screening trials for prostate, lung, colorectal, and ovarian cancers had a corrected risk ratio (HRs) and 95% CIs for cancer survival, and in the PLCO cancer screening trial, no correlation between aspirin use and bladder, breast, esophageal, stomach, pancreatic, or uterine cancer rates was found in this study.
researchers did find a positive correlation between taking aspirin and bladder and breast cancer survival rates, although this was not apparent in esophageal, stomach, pancreatic and uterine cancer survival rates.
results further demonstrate that aspirin can improve survival rates in some cancer patients.
previous studies have focused on gastrointestinal cancer, this analysis extends the benefits of aspirin use to other cancers, such as bladder and breast cancer.
, however, the benefits and harms of taking aspirin over time must be considered, although it may have a cancer-prevention effect.
: Loomans-Kropp HA, Pinsky P, Umar A. Evaluation of Aspirin Use With Cancer Division and Survival Among Older Adults in The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. JAMA Netw Open. 2021; 4(1):e2032072. doi:10.1001/jamanetworkopen.2020.32072MedSci Original Source: MedSci Original Copyright Notice: All noted on this website "Source: Mets Medicine" or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medical, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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