Use of aspirin postdiagnosis improves survival for colon cancer patients

E. Bastiaannet, K. Sampieri, O. M. Dekkers, A. J. de Craen, M. P. van Herk-Sukel, V. Lemmens, C. B. van den Broek, J. W. Coebergh, R. M. Herings, C. J. van de Velde, R. Fodde, G. J. Liefers

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The preventive role of non-steroid anti-inflammatory drugs (NSAIDs) and aspirin, in particular, on colorectal cancer is well established. More recently, it has been suggested that aspirin may also have a therapeutic role. Aim of the present observational population-based study was to assess the therapeutic effect on overall survival of aspirin/NSAIDs as adjuvant treatment used after the diagnosis of colorectal cancer patients. METHODS: Data concerning prescriptions were obtained from PHARMO record linkage systems and all patients diagnosed with colorectal cancer (1998-2007) were selected from the Eindhoven Cancer Registry (population-based cancer registry). Aspirin/NSAID use was classified as none, prediagnosis and postdiagnosis and only postdiagnosis. Patients were defined as non-user of aspirin/NSAIDs from the date of diagnosis of the colorectal cancer to the date of first use of aspirin or NSAIDs and user from first use to the end of follow-up. Poisson regression was performed with user status as time-varying exposure. RESULTS: In total, 1176 (26%) patients were non-users, 2086 (47%) were prediagnosis and postdiagnosis users and 1219 (27%) were only postdiagnosis users (total n=4481). Compared with non-users, a survival gain was observed for aspirin users; the adjusted rate ratio (RR) was 0.77 (95% confidence interval (CI) 0.63-0.95; P=0.015). Stratified for colon and rectal, the survival gain was only present in colon cancer (adjusted RR 0.65 (95%CI 0.50-0.84; P=0.001)). For frequent users survival gain was larger (adjusted RR 0.61 (95%CI 0.46-0.81; P=0.001). In rectal cancer, aspirin use was not associated with survival (adjusted RR 1.10 (95%CI 0.79-1.54; P=0.6). The NSAIDs use was associated with decreased survival (adjusted RR 1.93 (95%CI 1.70-2.20; P
Original languageEnglish
Pages (from-to)1564-1570
Number of pages7
JournalBritish journal of cancer
Volume106
Issue number9
DOIs
Publication statusPublished - 2012

Keywords

  • Adult Aged Aged, 80 and over Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use Aspirin/*therapeutic use Colonic Neoplasms/*diagnosis/epidemiology/*prevention & control Female Follow-Up Studies Humans Male Middle Aged Neoplasm Staging Netherlands/epidemiology Prognosis Rectal Neoplasms/*diagnosis/epidemiology/*prevention & control Risk Factors Survival Rate Young Adult

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