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Aspirin use and the incidence of breast, colon, ovarian, and pancreatic cancers in elderly women in the Iowa Women’s Health Study

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Abstract

Purpose

Few studies have evaluated the chemopreventive effect of aspirin on the cancer risk in elderly women. We examined associations between frequency, dose, and duration of aspirin use with incidence of 719 aspirin-sensitive cancers (cancers of colon, pancreas, breast, and ovaries) in the Iowa Women’s Health Study (IWHS), a prospective cohort of women over 70 years old.

Methods

Aspirin frequency, dose, and duration were self-reported in the 2004 IWHS questionnaire. Women were followed-up to 2011. Cancer cases were ascertained by linkage to the Iowa State Health Registry. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CI).

Results

Among the 14,386 women, 30 % were nonusers of aspirin; 34 % used low-dose aspirin, and 36 % used regular- or high-dose aspirin. Compared with nonuse of aspirin, the HRs (95 % CI) for incidence of aspirin-sensitive cancers were 0.87 (0.72–1.06) for regular to high doses of aspirin use, 0.95 (0.80–1.13) for aspirin use 6+ times per week, and 0.93 (0.74–1.17) for aspirin use for 10+ years. For cumulative aspirin use, HR (95 % CI) was 0.87 (0.70–1.09) for >60,000 mg of aspirin per year and 0.95 (0.75–1.21) for >280,000 mg of aspirin in their lifetime, versus nonuse of aspirin. Results were similar for the all-cause cancer death as an endpoint, with a significant inverse association observed between lifetime aspirin dose and cancer mortality [<95,000 mg vs nonuser HR 0.76 (0.61–0.95)].

Conclusions

These findings suggest that aspirin use may prevent incident breast, colon, pancreatic, and ovarian cancer in elderly women.

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References

  1. Howlader N, Noone AM, Krepcho M et al (2013) SEER cancer statistics review, 1975–2010. National Cancer Institute. http://seer.cancer.gov/csr/1975_2010/. Accessed 11 Apr 2016

  2. Administration on Aging (2012) A profile of older Americans: 2012. U.S. Department of Health and Human Services, Washington

    Google Scholar 

  3. Suzman R, Willis DP (eds) (1992) Introducing the oldest old. Oxford University Press, New York

    Google Scholar 

  4. Harding C, Pompei F, Wilson R (2009) Peak and decline in cancer incidence, mortality, and prevalence at old ages. Cancer 118(5):1371–1386

    Article  Google Scholar 

  5. Rothwell PM, Fowkes GR, Belch JFF, Ogawa H, Warlow CP, Meade TW (2011) Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet 377(9759):31–41

    Article  CAS  PubMed  Google Scholar 

  6. Anderson KE, Johnson TW, Lazovich D, Folsom AR (2002) Association between nonsteroidal anti-inflammatory drug use and the incidence of pancreatic cancer. J Natl Cancer Inst 94(15):1168–1171

    Article  PubMed  Google Scholar 

  7. Bardia A, Ebbert JO, Vierkant RA et al (2007) Association of aspirin and nonaspirin nonsteroidal anti-inflammatory drugs with cancer incidence and mortality. J Natl Cancer Inst 99(11):881–889

    Article  CAS  PubMed  Google Scholar 

  8. Bardia A, Olson JE, Vachon CM et al (2011) Effect of aspirin and other NSAIDs on postmenopausal breast cancer incidence by hormone receptor status: results from a prospective cohort study. Breast Cancer Res Treat 126(1):149–155

    Article  CAS  PubMed  Google Scholar 

  9. Cerhan JR, Anderson KE, Janney CA, Vachon CM, Witzig TE, Habermann TM (2003) Association of aspirin and other non-steroidal anti-inflammatory drug use with incidence of non-Hodgkin lymphoma. Int J Cancer 106(5):784–788

    Article  CAS  PubMed  Google Scholar 

  10. Jacobs EJ (2011) Will an aspirin a day help keep fatal cancer away? Lancet 377(9759):3–4

    Article  PubMed  Google Scholar 

  11. Johnson TW, Anderson KE, Lazovich D, Folsom AR (2002) Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. Cancer Epidemiol Biomark Prev 11(12):1586–1591

    CAS  Google Scholar 

  12. Prizment AE, Folsom AR, Anderson KE (2010) Nonsteroidal anti-inflammatory drugs and risk for ovarian and endometrial cancers in the Iowa Women’s Health Study. Cancer Epidemiol Biomark Prev 19(2):435–442

    Article  CAS  Google Scholar 

  13. Thun MJ, Jacobs EJ, Patrono C (2012) The role of aspirin in cancer prevention. Nat Rev Clin Oncol 9(5):259–267

    Article  CAS  PubMed  Google Scholar 

  14. Rose S (2013) A role for aspirin in cancer prevention? Cancer Discov 3(12):1324

    Article  CAS  Google Scholar 

  15. Cao Y, Nishihara R, Wu K et al (2016) Population-wide impact of long-term use of aspirin and the risk for cancer. JAMA Oncol. doi:10.1001/jamaoncol.2015.6396

    PubMed Central  Google Scholar 

  16. Rothwell PM, Price JF, Fowkes GR et al (2012) Short-term effectsof daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet 379(9826):1602–1612

    Article  CAS  PubMed  Google Scholar 

  17. Chubak J, Whitlock EP, Williams SB et al (2016) Aspirin for the prevention of cancer incidence and mortality: systematic evidence reviews for the U.S. Preventive Services Task Force. Ann Intern Med. doi:10.7326/M15-2117

    PubMed  Google Scholar 

  18. Siu AL (2016) Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 164:279–296. doi:10.7326/M15-2886

    Article  PubMed  Google Scholar 

  19. USPSTF (2008) U.S. Preventive Service Task Force. Screening for colorectal cancer. Current recommendation. http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm. Accessed 12 Jan 2014

  20. Hutchins LF, Unger JM, Crowley JJ, Coltman CA, Albain KS (1999) Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med 341:2061–2067

    Article  CAS  PubMed  Google Scholar 

  21. Cuzick J, Otto F, Baron JA et al (2009) Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement. Lancet Oncol 10(5):501–507

    Article  CAS  PubMed  Google Scholar 

  22. Algra AM, Rothwell PM (2012) Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials. Lancet Oncol 13(5):518–527

    Article  CAS  PubMed  Google Scholar 

  23. Bisgard KM, Folsom AR, Hong CP, Sellers TA (1994) Mortality and cancer rates in nonrespondents to a prospective study of older women: 5-year follow-up. Am J Epidemiol 139:990–1000

    CAS  PubMed  Google Scholar 

  24. WCRF/AICR (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. World Cancer Research Fund/American Institute for Cancer Research, Washington

    Google Scholar 

  25. Inoue-Choi M, Ward MH, Cerhan JR, Weyer PH, Anderson KE, Robien K (2013) Adherence to the WCRF/AICR guidelines for cancer prevention is associated with lower mortality among older female cancer survivors. Cancer Epidemiol Biomark Prev 22(5):792–802

    Article  Google Scholar 

  26. Zhang S, Folsom AR, Sellers TA, Kushi LH, Potter JD (1995) The Iowa Women’s Health Study. Better breast cancer survival for postmenopausal women who are less overweight and eat less fat. Cancer 76:275–283

    Article  CAS  PubMed  Google Scholar 

  27. Bosetti C, Rosato V, Gallus S, Cuzick J, La Vecchia C (2012) Aspirin and cancer risk: a quantitative review to 2011. Ann Oncol 23(6):1403–1415

    Article  CAS  PubMed  Google Scholar 

  28. Mahipal A, Anderson KE, Limburg PJ, Folsom AR (2006) Nonsteroidal anti-inflammatory drugs and subsite-specific colorectal cancer incidence in the Iowa Women’s Health Study. Cancer Epidemiol Biomark Prev 15(10):1785–1790

    Article  CAS  Google Scholar 

  29. Trabert B, Ness RB, Lo-Ciganic W et al (2014) Aspirin, non-aspirin nonsteroidal anti-inflammatory drug, and acetaminophen use and risk of invasive epithelial ovarian cancer: a pooled analysis in the Ovarian Cancer Association Consortium. J Natl Cancer Inst 106(2):djt431

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Baandrup L, Faber MT, Christensen J et al (2013) Nonsteroidal anti-inflammatory drugs and risk of ovarian cancer: systematic review and meta-analysis of observational studies. Acta Obstet Gynecol Scand 92(3):245–255

    Article  CAS  PubMed  Google Scholar 

  31. Zhang YP, Wan YD, Sun YL, Li J, Zhu RT (2015) Aspirin might reduce the incidence of pancreatic cancer: a meta-analysis of observational studies. Sci Rep 5:15460

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Qiu W, Chavarro J, Lazarus R, Rosner B, Ma J (2012) powerSurvEpi: power and sample size calculation for survival analysis of epidemiological studies. R package version 0.0.6. http://CRAN.R-project.org/package=powerSurvEpi

  33. R Core Team (2013) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0. http://www.R-project.org/

  34. Therneau T, Lumley T (2014) A package for survival analysis in S. R package version 2.37-7. http://CRAN.R-project.org/package=survival

  35. Bardia A, Keenan TE, Ebbert JO et al (2015) Personalizing aspirin use for targeted breast cancer chemoprevention in postmenopausal women. Mayo Clin Proc 91(1):71–80

    Article  CAS  PubMed  Google Scholar 

  36. USPSTF (2016) U.S. Preventive Service Task Force. aspirin use to prevent cardiovascular disease and colorectal cancer: preventive medication. Final update summary http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer?ds=1&s=aspirin. Accessed 15 Apr 2016

  37. Cho H, Klabunde C, Yabroff KR et al (2013) Comorbidity-adjusted life expectancy: a new tool to inform recommendations for optimal screening strategies. Ann Intern Med 159:667–676

    Article  PubMed  Google Scholar 

  38. ASPREE Investigator Group (2013) Study design of ASPirin in Reducing Events in the Elderly (ASPREE): a randomized, controlled trial. Contemp Clin Trials 36:555–564

    Article  PubMed Central  Google Scholar 

  39. Lazovich D, Robien K, Cutler G, Virnig B, Sweeney C (2009) Quality of life in a prospective cohort of elderly women with and without cancer. Cancer 115(18 suppl):4283–4297

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This study was supported by National Institutes of Health (NIH) Grant R01 CA039742. AEP was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award UL1TR000114.

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Correspondence to Kristin E. Anderson.

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Vaughan, L.E., Prizment, A., Blair, C.K. et al. Aspirin use and the incidence of breast, colon, ovarian, and pancreatic cancers in elderly women in the Iowa Women’s Health Study. Cancer Causes Control 27, 1395–1402 (2016). https://doi.org/10.1007/s10552-016-0804-8

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