Effect of aspirin and NSAIDs on risk and survival from colorectal cancer. Issue 12 (15th September 2010)

• Record Type: Journal Article
• Authors: Din, Farhat V N; Theodoratou, Evropi; Farrington, Susan M; Tenesa, Albert; Barnetson, Rebecca A; Cetnarskyj, Roseanne; Stark, Lesley; Porteous, Mary E; Campbell, Harry; Dunlop, Malcolm G
• Is Part Of: Gut. Volume 59:Issue 12(2010)
• Page Start: 1670
• Page End: 1679
• Publication Date: 2010-09-15
• Subjects: Colorectal cancer -- aspirin -- NSAIDs -- chemoprevention -- cancer prevention -- non-steroidal anti-inflammatory drugs; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2009.203000
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Previous studies have shown that aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) lower colorectal cancer (CRC) risk. However, the lowest effective NSAID dose, treatment duration, and effects on survival are not defined. In a large population-based case–control study, we have explored the relationship between NSAID dose and duration, CRC risk and overall CRC-specific survival. Methods: The relationship between NSAID use and CRC risk was examined in 2279 cases and 2907 controls. Subjects completed food-frequency and lifestyle questionnaires. NSAID categories were low-dose aspirin (75 mg), non-aspirin NSAIDs (NA-NSAIDs) and any NSAID. Users were defined as taking >4 tablets/week for >1 month. ORs were calculated by logistic regression models and adjusted for potential confounding factors. Effect of NSAID use on all-cause and CRC-specific mortality was estimated using Logrank tests and Cox's hazard models. Results: In all, 354 cases (15.5%) were taking low-dose aspirin compared to 526 controls (18.1%). Low-dose aspirin use was associated with decreased CRC risk (OR 0.78 95% CI 0.65 to 0.92, p=0.004), evident after 1 year and increasing with duration of use (ptrend =0.004). NA-NSAID and any NSAID use were also inversely associated with CRC. There was no demonstrable effect of NSAIDS on all-cause (HR 1.11, p=0.22, 0.94–1.33) or CRC-specific survival (HR 1.01, p=0.93, 0.83–1.23). Conclusion: This is the first study to demonstrate a protective effect against CRC associated with the lowest dose of aspirin (75 mg per day) after only 5 years use in the general population. NSAID use prior to CRC diagnosis does not influence survival from the disease.