Aspirin and other non-steroidal anti-inflammatory drugs and risk of colorectal cancer: A Danish cohort study
The optimal duration and dose of aspirin and non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) in the potential prevention of colorectal cancer (CRC) have not been established. We examined this issue in the Danish Diet, Cancer, and Health Study.
Self-reported NSAID use at entry (January 1995–May 1997) was updated through June 2006, using a nationwide prescription database. CRC incidence was ascertained from nationwide registers. Cox proportional hazards regression was used to compute confounder-adjusted incidence rate ratios (RRs) and 95% confidence intervals (CIs).
From 51,053 cohort subjects, we identified 615 CRC cases during 1995–2006. Daily aspirin use at entry was associated with a decreased risk of CRC (RR, 0.73; 95% CI, 0.49–1.10). A similar risk reduction was seen among subjects with 10 or more prescriptions for aspirin or non-aspirin NSAIDs and five or more years of follow-up. Most aspirin prescriptions were for 75–150 mg aspirin tablets. Among non-aspirin NSAID users, only those with body mass index (BMI) above 25 showed risk reductions [RR, 0.69 (0.47–1.03) for 10 or more prescriptions].
Long-term consistent use of aspirin or non-aspirin NSAIDs appears necessary to achieve a protective effect against CRC. Further studies of the effective dose of aspirin and the potential interaction between NSAID use and BMI are warranted.
KeywordsNon-steroidal anti-inflammatory agents Colorectal neoplasms Risk Epidemiology Cohort study
We thank Mathias Budinger, MSc, Institute of Medical Biometry, Epidemiology, and Informatics, Johannes Gutenberg University, Mainz, Germany, for help with the data management.
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