Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Loomans-Kropp, Holli A.; Pinsky, Paul F.; Umar, Asad

doi:10.1001/jamanetworkopen.2020.32072

Cited by 23 publications

(17 citation statements)

References 55 publications

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“…Of the 20 included articles which include our studies, finally contains 31 studies. In these studies, nine were conducted in the North America ( 29 – 31 , 33 – 36 , 44 , 45 ), four in Asia ( 38 , 41 , 42 ), four in Europe ( 32 , 37 , 46 , 47 ), and three in multi-regions ( 39 , 40 , 43 ). Among all studies enrolled, eleven were cohort studies ( 29 , 30 , 34 , 38 – 42 , 44 – 46 ), and eight were case-control studies ( 31 – 33 , 35 – 37 , 47 ) containing this study.…”

Section: Resultsmentioning

confidence: 99%

“…The selected studies were published between 2004 and 2021. Combined with our study, eight studies originated from the USA (52, 53, 55-60), one was from Italy (61), one was from India (54) and one was from multiregions (39). The sample size of the trials ranged from 43 to 139896.…”

Section: Characteristics Of the Studiesmentioning

confidence: 97%

“…In these studies, nine were conducted in the North America (29-31, 33-36, 44, 45), four in Asia (38,41,42), four in Europe (32,37,46,47), and three in multi-regions (39,40,43). Among all studies enrolled, eleven were cohort studies (29,30,34,(38)(39)(40)(41)(42)(44)(45)(46), and eight were case-control studies (31-33, 35-37, 47) containing this study. The given sample size of the trials ranged from 839 to 612509, with a total of more than 39524 patients with BCa.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…The sample size of the trials ranged from 43 to 139896. Among the twelve studies enrolled, eleven were cohort studies (39,(52)(53)(54)(55)(56)(57)(58)(59)(60)(61), and only one was case-control study.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment

et al. 2021

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Aspirin, widely used to prevent cardiovascular disease, had been linked to the incidence of bladder cancer (BCa). Existing studies focusing on Chinese populations are relatively rare, especially for Northeast China. Meanwhile, relevant studies on the effects of aspirin on the occurrence or prognosis of BCa are inconsistent or even controversial. First, in the case control study, logistic regression analysis was used to investigate the association between aspirin intake and risk of BCa including 1121 patients with BCa and the 2242 controls. Subsequently, Kaplan-Meier curve and Cox regression analyses were applied to explore the association between aspirin intake and clinicopathological factors which may predict overall survival (OS) and recurrence-free survival (RFS) of BCa patients. Finally, we quantificationally combined the results with those from the published literature evaluating aspirin intake and its effects on the occurrence, outcome of surgery and prognosis of BCa by meta-analysis up to May 1, 2021.Our case-control study demonstrated that the regular use of aspirin was not associated with a reduced incidence of BCa (P=0.175). Stratified analyses of sex showed that aspirin intake did not lead to a lower risk of BCa in female patients (P=0.063). However, the male population who regularly took aspirin had a lower incidence of BCa (OR=0.748, 95% CI= 0.584-0.958, P=0.021). Subgroup analyses stratified by smoking found a significant reduction in the risk of BCa in current smokers with aspirin intake (OR=0.522, 95% CI=0.342-0.797, P=0.002). In terms of prognosis of BCa, patients with a history of aspirin intake did not had a markedly longer OS or RFS than those with no history of aspirin intake by Kaplan-Meier curves. Stratified analysis by sex showed no correlation between aspirin intake and the recurrence or survival of BCa for either male or female patients. However, in people younger than 68, aspirin intake seemed to have prolonged effects for overall survival (HR=3.876; 95% CI=1.326-11.325, P=0.019). Then, we performed a meta-analysis and the combined results from 19 articles and our study involving more than 39524 BCa cases indicated that aspirin intake was not associated with the occurrence of BCa (P=0.671). Subgroup analysis by whether regular use of aspirin, by the mean duration of use of aspirin, by sex, by smoking exposure, by research region and by study type also supported the above results. In terms of the impact of aspirin intake on the prognosis of patients with BCa, 11 articles and our study involving 8825 BCa cases were eligible. The combined results showed that patients with aspirin intake did not have significantly influence on survival, recurrence, progression and metastasis than those without aspirin intake. On the whole, both our retrospective study and literature meta-analysis suggested a lack of a strong relevant association between the use of aspirin and the incidence or prognosis of BCa. Thus, additional long-term follow-up prospective research is warranted to clarify the association of aspirin with BCa incidence and prognosis.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 97%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment

et al. 2021

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“…[34][35][36] Aspirin has been linked to an improved survival in cancer. [37][38][39] Specifically in brain tumors there is epidemiological data to suggest that regular aspirin use is associated with decreased glioma risk. 40 Recognizing the limitations of retrospect analyses, there may be unaccounted confounders at play such as selection bias of a population considered to have prognosis sufficient to warrant cardiovascular risk modification.…”

Section: Discussionmentioning

confidence: 99%

Antiplatelet medications and risk of intracranial hemorrhage in patients with metastatic brain tumors

Miller¹,

Patell

Uhlmann

et al. 2022

Blood Advances

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Although intracranial hemorrhage (ICH) is frequent in the setting of brain metastases, there are limited data on the influence of antiplatelet agents on the development of brain-tumor associated ICH. To evaluate whether the administration of anti-platelet agents increases the risk of ICH, we performed a matched cohort analysis of patients with metastatic brain tumors with blinded radiology review. Study population included 392 patients with metastatic brain tumors (134 received antiplatelet agents and 258 controls). Non-small cell lung cancer was the most common malignancy in the cohort (74.0%), followed by small cell lung cancer (9.9%), melanoma (4.6%), and renal cell cancer (4.3%). Among those who received an antiplatelet agent, 86.6% received aspirin alone and 23.1% received therapeutic anticoagulation during the study period. The cumulative incidence of any ICH at one year was 19.3% (95% CI, 14.1-24.4%) in patients not receiving anti-platelet agents compared to 22.5% (95% CI, 15.2-29.8%, Gray test P=0.22) in those receiving anti-platelet agents. Cumulative incidence of major ICH was 5.4% (95% CI, 2.6-8.3%) among controls compared with 5.5% (95% CI, 1.5-9.5%, P=0.80) in those exposed to antiplatelet agents. The combination of anticoagulation with antiplatelet agents did not increase the risk of major ICH. The use of antiplatelet agents was not associated with an increase in the incidence, size, or severity of ICH in the setting of brain metastases.

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Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer

Loomans-Kropp

Umar

2023

JAMA Netw Open

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ImportanceIn a population with significantly increasing rates of individuals with overweight or obesity, understanding the association of obesity with long-term disease risk, such as cancer, is necessary to improve public health.ObjectiveTo investigate the association between body mass index (BMI) and gastrointestinal (GI) cancer risk (colorectal cancer [CRC] and noncolorectal GI cancer) in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.Design, Setting, and ParticipantsThis retrospective cohort study was a secondary analysis of data from the PLCO Cancer Screening Trial. Participants aged 55 to 74 years were enrolled and randomized to the intervention (screening group) or control group at 10 screening centers between November 8, 1993, and July 2, 2001. The initial analysis of PLCO Cancer Screening Trial data occurred after 13 years of follow-up or December 31, 2009, whichever came first. Participants were reconsented in 2011 and either continued follow-up or refused additional follow-up. For those who reconsented, follow-up for incident cancers continued until December 31, 2014, or death, whichever occurred first. Data analysis for this secondary analysis was performed from April 2022 through November 2022.ExposuresBody mass index and aspirin use, defined as the frequency of use of aspirin or aspirin-containing substances in the last 12 months.Main Outcomes and MeasuresThe primary outcomes were the diagnoses of CRC and noncolorectal GI cancer. The association between BMI and cancer (CRC and noncolorectal GI cancer) was assessed using Cox proportional hazards regression modeling. The association between cancer risk and change in BMI was further analyzed at different ages, and an exploratory analysis was performed to evaluate GI cancer risk among aspirin users.ResultsThis analysis included 135 161 participants (median [range] age, 62 [55-78] years; 67 643 [50.0%] female). Overweight BMI in early adulthood (hazard ratio [HR], 1.23; 95% CI, 1.10-1.37) and overweight BMI in middle adulthood (HR, 1.23; 95% CI, 1.13-1.34) and later adulthood (HR, 1.21; 95% CI, 1.10-1.32) as well as obese BMI in middle adulthood (HR, 1.55; 95% CI, 1.38-1.75) and later adulthood (HR, 1.39; 95% CI, 1.25-1.54) were associated with increased risk of CRC. Similar results were observed for the association with overall GI and non-CRC GI risk and BMI in middle and later adulthood. Maintaining overweight or obese BMI or increasing BMI to overweight or obese in later adulthood was also associated with increased CRC risk. Aspirin use 3 or more times per week did not significantly modify this association.Conclusions and RelevanceIn this secondary analysis of the PLCO Cancer Screening Trial, overweight and obese BMI in early and middle adulthood was associated with an elevated risk of CRC and noncolorectal GI cancers. The results of the current study prompt further exploration into the mechanistic role of obese BMI in carcinogenesis.

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Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Cited by 23 publications

References 55 publications

Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment

Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment

Antiplatelet medications and risk of intracranial hemorrhage in patients with metastatic brain tumors

Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer

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