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Low-dose aspirin use and survival in colorectal cancer: results from a population-based cohort study
Ronan T Gray1, Helen G Coleman2, Carmel Hughes3
1Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, Northern Ireland, BT12 6BA, UK. rgray05@qub.ac.uk.
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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