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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:
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
Publisher: London: BMJ Publishing Group Ltd and British Society of Gastroenterology
ID: ISSN: 0017-5749
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recordid: cdi_proquest_miscellaneous_1753476937
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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0Din, Farhat V N
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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0Effect of aspirin and NSAIDs on risk and survival from colorectal cancer
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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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1Adult
2Age
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4Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
5Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
6Anticarcinogenic Agents - administration & dosage
7Anticarcinogenic Agents - therapeutic use
8Aspirin
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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5Cetnarskyj, Roseanne
6Stark, Lesley
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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1Adult
2Age
3Aged
4Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
5Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
6Anticarcinogenic Agents - administration & dosage
7Anticarcinogenic Agents - therapeutic use
8Aspirin
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
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45Risk factors
46Scotland - epidemiology
47Smoking - epidemiology
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49Studies
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52Womens health
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7Porteous, Mary E
8Campbell, Harry
9Dunlop, Malcolm G
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0Din, Farhat V N
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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atitleEffect of aspirin and NSAIDs on risk and survival from colorectal cancer
jtitleGut
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volume59
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pages1670-1679
issn0017-5749
eissn1468-3288
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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