Journal
BMC CANCER
Volume 18, Issue -, Pages -Publisher
BIOMED CENTRAL LTD
DOI: 10.1186/s12885-018-4142-y
Keywords
Aspirin; Colorectal cancer; Survival; Pharmaco-epidemiology
Categories
Funding
- Queen's University Belfast
- Health & Social Care Research and Development Division of the Public Health Agency (HSC R&D Division) Doctoral Fellowship
- Cancer Research UK Population Health Postdoctoral Fellowship
- Cancer Research UK [17592] Funding Source: researchfish
- Medical Research Council [MC_CF023241] Funding Source: researchfish
- Public Health Agency [EAT/4905/13] Funding Source: researchfish
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Background: Aspirin has been proposed as a novel adjuvant agent in colorectal cancer (CRC). Six observational studies have reported CRC-specific survival outcomes in patients using aspirin after CRC diagnosis but the results from these studies have been conflicting. Using a population-based cohort design this study aimed to assess if low-dose aspirin use after diagnosis reduced CRC-specific mortality. Methods: A cohort of 8391 patients with Dukes' A-C CRC (2009-2012) was identified from the Scottish Cancer Registry and linked to national prescribing and death records. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC-specific mortality were calculated using time-dependent Cox regression. Results: There were 1064 CRC-specific deaths after a median follow-up of 3.6 years. Post-diagnostic low-dose aspirin use was not associated with a reduction in CRC-specific mortality either before or after adjustment for confounders (adjusted HR = 1.17, 95% CI 1.00-1.36). In sensitivity analysis pre-diagnostic low-dose aspirin was also not associated with reduced CRC-specific mortality (adjusted HR = 0.96, 95% CI 0.88-1.05). Conclusion: Low-dose aspirin use, either before or after diagnosis, did not prolong survival in this population-based CRC cohort.
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