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Effect of aspirin and NSAIDs on risk and survival from colorectal cancer

BackgroundPrevious 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 ha... Full description

Journal Title: Gut 2010, Vol.59 (12), p.1670-1679
Main Author: Din, Farhat V N
Other Authors: Theodoratou, Evropi , Farrington, Susan M , Tenesa, Albert , Barnetson, Rebecca A , Cetnarskyj, Roseanne , Stark, Lesley , Porteous, Mary E , Campbell, Harry , Dunlop, Malcolm G
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Publisher: London: BMJ Publishing Group Ltd and British Society of Gastroenterology
ID: ISSN: 0017-5749
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title: Effect of aspirin and NSAIDs on risk and survival from colorectal cancer
format: Article
creator:
  • 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
subjects:
  • Adolescent
  • Adult
  • Age
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
  • Anticarcinogenic Agents - administration & dosage
  • Anticarcinogenic Agents - therapeutic use
  • Aspirin
  • Aspirin - administration & dosage
  • Aspirin - therapeutic use
  • Bias
  • Biological and medical sciences
  • Bones, joints and connective tissue. Antiinflammatory agents
  • cancer prevention
  • Care and treatment
  • chemoprevention
  • Colorectal cancer
  • Colorectal Neoplasms - epidemiology
  • Colorectal Neoplasms - prevention & control
  • Confounding Factors (Epidemiology)
  • Diet - statistics & numerical data
  • Dosage and administration
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug dosages
  • Epidemiologic Methods
  • Family medical history
  • Female
  • Gastroenterology. Liver. Pancreas. Abdomen
  • Health risk assessment
  • Humans
  • Life Style
  • Lifestyles
  • Male
  • Medical sciences
  • Middle Aged
  • Mortality
  • non-steroidal anti-inflammatory drugs
  • Nonsteroidal anti-inflammatory drugs
  • NSAIDs
  • Patient outcomes
  • Pharmacology. Drug treatments
  • Population
  • Poverty - statistics & numerical data
  • Risk factors
  • Scotland - epidemiology
  • Smoking - epidemiology
  • Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
  • Studies
  • Surveillance
  • Tumors
  • Womens health
  • Young Adult
ispartof: Gut, 2010, Vol.59 (12), p.1670-1679
description: BackgroundPrevious 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.MethodsThe 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.ResultsIn 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).ConclusionThis 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.
language: eng
source:
identifier: ISSN: 0017-5749
fulltext: no_fulltext
issn:
  • 0017-5749
  • 1468-3288
url: Link


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titleEffect of aspirin and NSAIDs on risk and survival from colorectal cancer
creatorDin, 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
creatorcontribDin, 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
descriptionBackgroundPrevious 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.MethodsThe 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.ResultsIn 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).ConclusionThis 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.
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1Theodoratou, Evropi
2Farrington, Susan M
3Tenesa, Albert
4Barnetson, Rebecca A
5Cetnarskyj, Roseanne
6Stark, Lesley
7Porteous, Mary E
8Campbell, Harry
9Dunlop, Malcolm G
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descriptionBackgroundPrevious 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.MethodsThe 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.ResultsIn 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).ConclusionThis 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.
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2Age
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4Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
5Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
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9Aspirin - administration & dosage
10Aspirin - therapeutic use
11Bias
12Biological and medical sciences
13Bones, joints and connective tissue. Antiinflammatory agents
14cancer prevention
15Care and treatment
16chemoprevention
17Colorectal cancer
18Colorectal Neoplasms - epidemiology
19Colorectal Neoplasms - prevention & control
20Confounding Factors (Epidemiology)
21Diet - statistics & numerical data
22Dosage and administration
23Dose-Response Relationship, Drug
24Drug Administration Schedule
25Drug dosages
26Epidemiologic Methods
27Family medical history
28Female
29Gastroenterology. Liver. Pancreas. Abdomen
30Health risk assessment
31Humans
32Life Style
33Lifestyles
34Male
35Medical sciences
36Middle Aged
37Mortality
38non-steroidal anti-inflammatory drugs
39Nonsteroidal anti-inflammatory drugs
40NSAIDs
41Patient outcomes
42Pharmacology. Drug treatments
43Population
44Poverty - statistics & numerical data
45Risk factors
46Scotland - epidemiology
47Smoking - epidemiology
48Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
49Studies
50Surveillance
51Tumors
52Womens health
53Young Adult
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7Porteous, Mary E
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titleEffect of aspirin and NSAIDs on risk and survival from colorectal cancer
authorDin, 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
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2Age
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5Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
6Anticarcinogenic Agents - administration & dosage
7Anticarcinogenic Agents - therapeutic use
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9Aspirin - administration & dosage
10Aspirin - therapeutic use
11Bias
12Biological and medical sciences
13Bones, joints and connective tissue. Antiinflammatory agents
14cancer prevention
15Care and treatment
16chemoprevention
17Colorectal cancer
18Colorectal Neoplasms - epidemiology
19Colorectal Neoplasms - prevention & control
20Confounding Factors (Epidemiology)
21Diet - statistics & numerical data
22Dosage and administration
23Dose-Response Relationship, Drug
24Drug Administration Schedule
25Drug dosages
26Epidemiologic Methods
27Family medical history
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29Gastroenterology. Liver. Pancreas. Abdomen
30Health risk assessment
31Humans
32Life Style
33Lifestyles
34Male
35Medical sciences
36Middle Aged
37Mortality
38non-steroidal anti-inflammatory drugs
39Nonsteroidal anti-inflammatory drugs
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41Patient outcomes
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43Population
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45Risk factors
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47Smoking - epidemiology
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49Studies
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7Porteous, Mary E
8Campbell, Harry
9Dunlop, Malcolm G
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7Porteous, Mary E
8Campbell, Harry
9Dunlop, Malcolm G
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notesFVND & ET are joint first authors and contributed equally to this study.
abstractBackgroundPrevious 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.MethodsThe 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.ResultsIn 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).ConclusionThis 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.
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pubBMJ Publishing Group Ltd and British Society of Gastroenterology
pmid20844293
doi10.1136/gut.2009.203000