The Relationship Between Aspirin Use and Mortality in Colorectal Cancer

Abstract

Background: Aspirin use lengthens survival in patients with colorectal cancer (CRC). We aimed to add to the evidence examining this relationship and to compare the survival benefit between aspirin started before CRC diagnosis with those started after CRC diagnosis. Methods:The study involved 173 consecutive patients who had a histopathologic diagnosis of colorectal carcinoma between 1996 and 2014. The electronic medical record was used to collect data on demographic characteristics (age, sex, and race), family history of cancer, use or non-use of aspirin before and after cancer diagnosis, cancer stage at diagnosis, and days from cancer diagnosis to death. Patients were divided into aspirin using and non-aspirin using groups.Results: Aspirin users (ASAU, n=90) were older than non-aspirin users (NASAU, n=83; 70.8±9.1 vs. 66.2±10.2 years; P=0.004). The two groups were similar in sex, race, and family history of cancer, but the non-users of aspirin were more likely to have stage III or stage IV CRC (NASAU =57.5%; ASAU =38.6%; P=0.014). Aspirin users survived more than twice the number of days than non-users (ASAU median =941 days; NASAU median =384 days; P=0.003). Patients who used aspirin only before their CRC diagnosis had a short survival period from diagnosis to death (median =149).Conclusions: Our findings support the relationship of aspirin use and duration of use with enhanced survival in patients with CRC. Physicians may want to recommend that patients at increased risk for CRC and those already diagnosed, but not yet on aspirin, start an aspirin regimen.

Aspirin and cancer survival: a systematic review and meta-analyses of 118 observational studies of aspirin and 18 cancers

“…A number of authors give estimates of the association with aspirin in terms of the duration of the additional survival in patients taking the drug. Thus, Albandar [117] who followed 174 US veterans with colorectal cancer to death reported that the median survival of patients taking aspirin was 941 versus 384 days in those not taking aspirin. Several papers record an increased survival associated with aspirin taken by patients with liver cancer: in one 18 months additional survival [93]; in another 6% more patients survived 10 years with aspirin after diagnosis [103], and the median overall survival period after embolisation was longer for patients taking aspirin (57 versus 23 months) [119].…”

Aspirin inhibits endometrial fibrosis by suppressing the�TGF‑β1‑Smad2/Smad3 pathway in intrauterine adhesions

“…Aspirin is a non-steroidal anti-inflammatory drug whose primary active component is acetylsalicylic acid (16). Aspirin is clinically used to decrease fever, inflammation, cardiovascular disease and certain types of cancer (17)(18)(19). Jiang et al (20) described the association between the use of aspirin and liver fibrosis in 1,856 patients with chronic liver disease in the USA.…”

Aspirin use predicts prolonged survival in patients with oropharyngeal cancer: Nationwide Veterans Affairs database study

“…A recent cohort study by Loomans‐Kropp et al involving over 140 000 individuals enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial found that aspirin use at least three times per week was associated with reductions in all‐cause cancer mortality 23 . In veterans, a similar prognostic benefit has been demonstrated in those with colorectal cancer who regularly used aspirin, even after adjusting for age and cancer stage 24 . The protective effect of aspirin and other NSAIDs on survival extends to patients with head and neck cancer as well 13,14 …”

“…23 In veterans, a similar prognostic benefit has been demonstrated in those with colorectal cancer who regularly used aspirin, even after adjusting for age and cancer stage. 24 The protective effect of aspirin and other NSAIDs on survival extends to patients with head and neck cancer as well. 13,14 Aspirin and other NSAIDs act via the PI3K signaling pathway, which is crucial to cell growth and survival in both the physiologic and pathologic state.…”