Low-dose acetylsalicylic acid for cancer prevention considering risk factors: a retrospective cohort study.

PURPOSE: Aspirin (acetylsalicylic acid) has been reported to protect against certain cancers. However, patient-related risk factors may moderate protective effects, including excess weight, smoking, risky alcohol use, and diabetes. We explore the cancer-risk relationship between aspirin intake and those four factors. METHODS: Retrospective cohort study of cancers, aspirin intake, and four risk factors in persons aged ≥50 years. Participants received medication during 2007-2016, and cancers were diagnosed in 2012-2016. Adjusted hazard ratios (aHR) for 95% confidence intervals (95%CI) were calculated for aspirin intake and risk factors using Cox proportional hazard modeling. RESULTS: Of 118,548 participants, 15,793 consumed aspirin, and 4003 had cancer. Results indicated a significant protective effect of aspirin against colorectal (aHR: 0.7; 95%CI: 0.6-0.8), pancreatic (aHR: 0.5; 95%CI: 0.2-0.9), prostate (aHR: 0.6; 95%CI: 0.5-0.7) cancers and lymphomas (aHR: 0.5; 95%CI: 0.2-0.9), and also, although not significantly, against esophageal (aHR: 0.5; 95%CI: 0.2-1.8), stomach (aHR: 0.7; 95%CI: 0.4-1.3), liver (aHR: 0.7; 95%CI: 0.3-1.5), breast (aHR: 0.8; 95%CI: 0.6-1.0), and lung and bronchial (aHR: 0.9; 95%CI: 0.7-1.2) cancers. Aspirin intake was not significantly protective against leukemia (aHR: 1.0; 95%CI: 0.7-1.4) or bladder cancer (aHR: 1.0; 95%CI: 0.8-1.3). CONCLUSIONS: Our results suggest that aspirin intake is associated with a reduced incidence of colorectal, pancreatic, and prostate cancers and lymphomas.

Acetylsalicylic Acid Effect in Colorectal Cancer Taking into Account the Role of Tobacco, Alcohol and Excess Weight.

Excess weight, smoking and risky drinking are preventable risk factors for colorectal cancer (CRC). However, several studies have reported a protective association between aspirin and the risk of CRC. This article looks deeper into the relationships between risk factors and aspirin use with the risk of developing CRC. We performed a retrospective cohort study of CRC risk factors and aspirin use in persons aged >50 years in Lleida province. The participants were inhabitants with some medication prescribed between 2007 and 2016 that were linked to the Population-Based Cancer Registry to detect CRC diagnosed between 2012 and 2016. Risk factors and aspirin use were studied using the adjusted HR (aHR) with 95% confidence intervals (CI) using a Cox proportional hazard model. We included 154,715 inhabitants of Lleida (Spain) aged >50 years. Of patients with CRC, 62% were male (HR = 1.8; 95% CI: 1.6-2.2), 39.5% were overweight (HR = 2.8; 95% CI: 2.3-3.4) and 47.3% were obese (HR = 3.0; 95% CI: 2.6-3.6). Cox regression showed an association between aspirin and CRC (aHR = 0.7; 95% CI: 0.6-0.8), confirming a protective effect against CRC and an association between the risk of CRC and excess weight (aHR = 1.4; 95% CI: 1.2-1.7), smoking (aHR = 1.4; 95% CI: 1.3-1.7) and risky drinking (aHR = 1.6; 95% CI: 1.2-2.0). Our results show that aspirin use decreased the risk of CRC and corroborate the relationship between overweight, smoking and risky drinking and the risk of CRC.

The Use of Multiple Correspondence Analysis to Explore Associations Between Categories of Qualitative Variables and Cancer Incidence.

BACKGROUND: Previous works have shown that risk factors for some kinds of cancer depend on people's lifestyle (e.g. rural or urban residence). This article looks into this, seeking relationships between cancer, age group, gender and population in the region of Lleida (Catalonia, Spain) using Multiple Correspondence Analysis (MCA). METHODS: The dataset analysed was made up of 3408 cancer episodes between 2012 and 2014, extracted from the Population-based Cancer Registry (PCR) for Lleida province. The cancers studied were colon and rectal (1059 cases), lung (551 cases), urinary bladder (446 cases), prostate (609 cases) and breast (743 cases). The MCA technique was applied and used to search relationships among the main qualitative features. The basic statistics were the percentage explaining (variance), the inertia and the contribution of each qualitative variable. RESULTS: General outcomes showed a low and moderate contribution of living in rural areas to colorectal and male prostate cancer. Males in urban areas were slightly and heavily affected by lung and urinary bladder cancer respectively. The analysis of each cancer provided additional information. Colorectal cancer greatly affected males aged <60, urban residents aged 70-79, and rural females aged ≥ 80. The impact of lung cancer was high among urban females <60, moderate among males aged 70-79 and high among rural females aged ≥ 80. The results for urinary bladder cancer results were similar to those for lung cancer. Prostate cancer affected both the <60 and ≥ 80 age groups significantly in rural areas. Breast cancer hit the 70-79 group significantly and, somewhat less so, rural females aged ≥ 80. CONCLUSIONS: MCA was a significant help for detecting the contributions of qualitative variables and the associations between them. MCA has proven to be an effective technique for analyzing the incidence of cancer. The outcomes obtained help to corroborate suspected trends, as well as detecting and stimulating new hypotheses about the risk factors associated with a specific area and cancer. These findings will be helpful for encouraging new studies and prevention campaigns to highlight observed singularities.