Aspirin May Prevent Cholangiocarcinoma: A Case–Control Study from the United Kingdom

Burr, Nicholas; Talboys, Rupert; Savva, S. C.; Clark, Allan; Phillips, Martin; Metcalfe, Matthew S.; Dennison, Ashley R.; Robinson, Richard; Lewis, Michael P.; Rhodes, Michael; Rushbrook, Simon; Hart, Andrew

doi:10.1007/s10620-014-3056-z

Cited by 21 publications

(14 citation statements)

References 22 publications

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“…These consistent findings indicated that aspirin use was significantly associated with a reduction in the risk of CCA regardless of the reason for taking aspirin. Interestingly, the AOR of aspirin use in this study was close to the AOR of 0.45 which was reported in a relatively small UK study of 81 CCA patients . Similarly, another study, conducted in China of 191 patients with extrahepatic bile duct cancer, demonstrated a comparable AOR of 0.48 (95% CI 0.19‐1.19) for aspirin ever‐users, although statistical significance was not reached .…”

Section: Discussionsupporting

confidence: 69%

“…Similarly, we were also not able to assess the possible influence of nonsteroidal anti‐inflammatory drugs (NSAIDs) on CCA in the analysis because of the heterogeneity of information on NSAID use, such as the diverse types of drugs, frequent dose changes, and frequency of intermittent use. Although NSAIDs have shown chemopreventive effects in certain types of cancer, two previous studies did not find a significant association between NSAID use and CCA . Also, due to the retrospective nature of this study, we were not able to obtain detailed smoking histories, which might have allowed a determination of the dose‐response relationship between smoking and CCA development.…”

Section: Discussionmentioning

confidence: 82%

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Aspirin use and the risk of cholangiocarcinoma‡

et al. 2016

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Whether aspirin use is protective against cholangiocarcinoma (CCA) remains unclear. We determined the association between aspirin use and other risk factors for each CCA subtype individually. In a hospital-based case-control study, 2395 CCA cases (1169 intrahepatic, 995 perihilar, and 231 distal) seen at the Mayo Clinic, Rochester, MN, from 2000 through 2014 were enrolled. Controls selected from the Mayo Clinic Biobank were matched two to one with cases by age, sex, race, and residence (n 5 4769). Associations between aspirin use, other risk factors, and CCA risk were determined. Aspirin was used by 591 (24.7%) CCA cases and 2129 (44.6%) controls. There was a significant inverse association of aspirin use with all CCA subtypes, with adjusted odds ratios (AORs) of 0.35 (95% confidence interval [CI], 0.29-0.42), 0.34 (95% CI 0.27-0.42), and 0.29 (95% CI 0.19-0.44) for intrahepatic, perihilar, and distal CCA, respectively (P < 0.001 for all). Primary sclerosing cholangitis was more strongly associated with perihilar (AOR 5 453, 95% CI 104-999) than intrahepatic (AOR 5 93.4, 95% CI 27.1-322) or distal (AOR 5 34.0, 95% CI 3.6-323) CCA, whereas diabetes was more associated with distal (AOR 5 4.2, 95% CI 2.5-7.0) than perihilar (AOR 5 2.9, 95% CI 2.2-3.8) or intrahepatic (AOR 5 2.5, 95% CI 2.0-3.2) CCA. Cirrhosis not related to primary sclerosing cholangitis was associated with both intrahepatic and perihilar CCA, with similar AORs of 14. Isolated inflammatory bowel disease without primary sclerosing cholangitis was not associated with any CCA subtype. Conclusions : Aspirin use was significantly associated with a 2.7-fold to 3.6-fold decreased risk for the three CCA subtypes; our study demonstrates that individual risk factors confer risk of different CCA subtypes to different extents.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 82%

Aspirin use and the risk of cholangiocarcinoma‡

et al. 2016

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“…These findings are particularly interesting as they confirm on a very large population previous data that showed an AOR of 0.45 in a relatively small UK study of 81 patients (5).…”

supporting

confidence: 87%

Cholangiocarcinoma: from risk to prevention?

Brandi¹,

Lorenzo

Tovoli

2016

Transl. Gastroenterol. Hepatol.

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“…The risk of CCA is increased with liver fluke infection, hepatitis B and C virus infection, cirrhosis, alcohol consumption and hepatolithiasis . At present, there are no definite strategies for CCA prevention, and epidemiological data indicate that chemoprevention provides no protective effect against the development of CCA .…”

Section: Introductionmentioning

confidence: 99%

Statins are associated with a reduced risk of cholangiocarcinoma: a population‐based case–control study

Peng

Lin

Hsu

et al. 2015

Brit J Clinical Pharma

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Aims Cholangiocarcinoma (CCA) is the second most common primary liver cancer in the world. Due to the lack of effective treatments, the survival rate of CCA is low and it is usually considered difficult to diagnose early. To date, no effective strategies for the prevention of CCA have been developed. Statins are cholesterol‐lowering agents which possess pleiotropic properties and the use of statins may reduce cancer risk. The aim of the study was to investigate the effect of statin use on the risk of CCA. Methods We used nationwide insurance data to perform a case–control study including 3174 CCA patients diagnosed in 2002–2011 and 3174 propensity score matched controls. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated to assess the association between CCA risk and statin use by type of statin and dose. Results Patients with CCA were slightly younger than controls with mean ages of 67.4 (SD 12.3) and 68.5 (SD 13.2) years (P = 0.001), respectively, and had less users of statins (22.7 vs. 26.5%, P < 0.001). The overall adjusted OR of statin use associated CCA was 0.80 (95% CI 0.71, 0.90) and lowered for those with longer medications. The OR ranged from 0.65 to 0.77. Stronger dose–response association was seen when using lovastatin. Conclusions Statin use is associated with reduced risk of CCA and there is a dose–response relationship between the use of statins and risk of CCA.

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Aspirin May Prevent Cholangiocarcinoma: A Case–Control Study from the United Kingdom

Cited by 21 publications

References 22 publications

Aspirin use and the risk of cholangiocarcinoma‡

Aspirin use and the risk of cholangiocarcinoma‡

Cholangiocarcinoma: from risk to prevention?

Statins are associated with a reduced risk of cholangiocarcinoma: a population‐based case–control study

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