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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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.
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).
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)].
These findings suggest that aspirin use may prevent incident breast, colon, pancreatic, and ovarian cancer in elderly women.
KeywordsAspirin NSAIDs Elderly Cohort Cancer Women
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.
- 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, WashingtonGoogle Scholar
- 3.Suzman R, Willis DP (eds) (1992) Introducing the oldest old. Oxford University Press, New YorkGoogle 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):1586–1591Google 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
- 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, WashingtonGoogle 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):djt431CrossRefPubMedPubMedCentralGoogle 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
- 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