Aspirin ‘may double life expectancy of cancer patients’

Study of 14,000 people with cancer in gastrointestinal tract finds regular users of drug twice as likely to be alive after four years

Over view from the Guardian via Aspirin ‘may double life expectancy of cancer patients’ | Society | The Guardian.

A daily dose of aspirin can double the life expectancy of patients with cancers affecting the gastrointestinal tract, according to a study. It was already known that that frequent use of aspirin can prevent bowel cancer, but the most recent study also suggests that men and women with a range of cancers who take the anti-inflammatory painkiller experience a significant survival benefit compared with those who do not. The study of 14,000 cancer patients in the Netherlands found that regular users of aspirin were twice as likely to still be alive after a four-year period as those who did not take the cheap drug. According to the report’s authors, the impact of aspirin on survival was seen after adjusting for factors such as gender, age, stage of cancer, treatments, and other medical conditions that could have influenced death rates.

Conference abstract via Searchable Programme for ECC2015.

Background:

Epidemiological evidence shows a dual role in the relation between aspirin and cancer; both preventative and therapeutic effects are suggested. The biological mechanism of aspirin is still part of debate. Stratification in specific localizations in the entire gastro intestinal tract could lead to new insights towards the effect of aspirin as a therapeutic agent. Previous research focused mainly on the effect in colorectal cancer. The objective of this retrospective cohort study is to determine the association of aspirin use solely post diagnosis and survival for all distinct gastro intestinal malignancies.

Material and Methods:

All patients with cancer of the gastro intestinal tract diagnosed between 1998 and 2011 were selected from the population-based Eindhoven Cancer Registry and linked to drug dispensing data from the PHARMO Database Network. The association between aspirin use after diagnosis and overall survival was analyzed using Cox regression models with time-varying exposure. Aspirin use was recorded in periods of use and no use per patient. Relative survival was estimated, defined as the ratio between the observed survival in the cohort and expected survival in the general population.

Results:

In total, 13.715 patients were diagnosed with a gastro intestinal malignancy, 4.187 (30.5%) used aspirin prediagnosis, 1.143 were solely postdiagnosis users (8.3%) and 8.385 (61.1%) were non-users. For this analyses, solely postdiagnosis users and nonusers were selected(n=9.528). The largest groups were colon (4081; 42.8%), rectal (2370; 24.9%) and esophageal (972; 10.2%) cancer patients. Median follow-up time for all patients was 26.5 months (range 0–180.7) with a five year overall survival of 56%. In total, 5.440 events were reported. Overall and relative survival for aspirin users will be presented at the congress.

Conclusion:

Aspirin use initiated after diagnosis of gastro intestinal malignancies is associated with higher overall and relative survival rates. In January 2015 the Aspirin trial started in the Netherlands. This phase III multicenter, placebo-controlled, randomised trial will study the effects of aspirin on recurrence and survival in elderly patients with stage II and III colon cancer.

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