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Just an abstract. Limited or no peer review so be careful. Here's the text. Background: Chemopreventive effect of aspirin on colorectal cancer (CRC) has been reported,
but there are indications that effects of aspirin are not limited to the colon or rectum. The
aim of this study is to evaluate the long-term use of low-dose aspirin at 80mg for other
gastrointestinal (GI) cancers. Method: A territory-wide dataset which includes all patients
admitted to public hospitals of Hong Kong were used to extract a cohort between 2000
and 2004 with long-term use of aspirin and matched against non-aspirin users in 1:2 ratio.
Further matching on survival time with duration of aspirin prescribed for at least 6 months
was conducted to avoid immortal bias. Patients' outcomes were documented for up to 14
years until 2013. Changes in cancer incidences on colon/rectum, liver, oesophagus, pancreas
and stomach were the primary outcomes. Cancer related mortalities were the secondary
outcomes. Odds ratio (OR) was used to measure the cancer incidence, and Sub-distribution
Hazard Ratio (SHR) for competing risk mortality was fitted to adjust for other cause-ofdeath.
Results: A total of 618,884 subjects were included; 206,295 aspirin users with average
aspirin prescribed for 7.7 years were matched with 412,589 non-aspirin users. The mean
ages of patients in aspirin and non-aspirin group were 67.5 years and 67.6 years respectively.
The median dose of aspirin prescribed was 80mg, and inter-quartile range was from 80 mg
to 100 mg. A total of 18,500 (2.99%) cases of CRC, 9,433 (1.52%) of hepatic cancer, 2,658
(0.43%) of oesophageal cancer, 2,796 (0.45%) of pancreatic cancer, and 5,877 (0.95%) of
gastric cancer were observed. Long term used of low-dose aspirin showed significant reduction
on cancer incidences for CRC (OR:0.76, 95% CI:0.73-0.78), hepatic cancer (OR:0.53, 95%
CI:0.51-0.56), oesophageal cancer (OR:0.53, 95% CI:0.49-0.59), pancreatic cancer (OR:0.66,
95% CI:0.60-0.71), and gastric cancer (OR:0.62, 95% CI:0.58-0.65). Long term used of
low-dose aspirin also showed significant reduction on mortality from GI cancers (Table 1).
Conclusion: Long-term use of low-dose aspirin, at 80mg, significantly reduced both incidence
and mortality from colorectal, hepatic, oesophageal, pancreatic and gastric cancers. |