Uso prediagnostico di aspirina a basso dosaggio e rischio di metastasi incidenti e mortalità per tutte le cause tra i pazienti con cancro del colon-retto

Stampa

Prediagnostic Use of Low-Dose Aspirin and Risk of Incident Metastasis and All-Cause Mortality Among Patients With Colorectal Cancer

  • Autori: Giorli G, Rouette J, Yin H, Lapi F, Simonetti M, Cricelli C, Pollak M, Azoulay L.
  • Published: 2020 April 30
  • Rivista: Br J Clin Pharmacol. doi: 10.1111/bcp.14329.
  • Link alla pubblicazione

Abstract

Aims: Previous studies suggest that the use of low‐dose aspirin before a colorectal cancer (CRC) diagnosis may be associated with a decreased risk of CRC progression. Data supporting this association, however, have been inconsistent. We evaluate whether the use of prediagnostic low‐dose aspirin is associated with a lower risk of metastases and all‐cause mortality in CRC patients.
Methods: Using a large Italian population‐based primary care database, we identified a cohort of 7478 patients newly diagnosed with nonmetastatic CRC between 2000 and 2013. Use of prediagnostic low‐dose aspirin was compared with no use of low‐dose aspirin. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of incident metastasis and of all‐cause mortality associated with prediagnostic low‐dose aspirin use, both overall and by duration of use.
Results: There were 314 incident metastatic events and 2189 deaths during a mean follow‐up time of 4.4 and 4.7 years, respectively. Overall prediagnostic use of low‐dose aspirin was not associated with a decreased risk of incident metastasis (HR 0.88; 95% CI 0.63–1.22) or all‐cause mortality (HR 1.09; 95% CI 0.96–1.22) in CRC patients. Cumulative duration of aspirin use was not associated with a decreased risk of incident metastasis (P‐trend = .22) or all‐cause mortality (P‐trend = .38). These findings remained consistent in sensitivity analyses.
Conclusion: In this real‐world, population‐based study, the prediagnostic use of low‐dose aspirin was not associated with a decreased risk of incident metastasis or all‐cause mortality in CRC patients.
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