A cohort study investigating aspirin use and survival in men with prostate cancer

作者：Flahavan E M; Bennett K; Sharp L; Barron T I^*

来源：Annals of Oncology, 2014, 25(1): 154-159.

DOI：10.1093/annonc/mdt428

• prostate neoplasm
• mortality
• aspirin
• pharmacoepidemiology

Background: Aspirin use has been associated with reduced mortality from cancer including prostate cancer in some studies. A number of anti-cancer mechanisms of aspirin have been proposed, including the inhibition of the cyclooxygenase enzymes, through which aspirin mediates both anti-platelet and anti-inflammatory activities. This cohort study examines associations between pre-diagnostic aspirin use (overall and by dose and dosing intensity) and mortality in men with localised prostate cancer. %26lt;br%26gt;Patients and methods: Men with stage I-Ill prostate cancer were identified from Irish National Cancer Registry records, which have been linked to national prescribing data from the Irish General Medical Services scheme. Aspirin use in the year preceding prostate cancer diagnosis was identified from this linked prescription-claims data. Adjusted hazard ratios (HAS) and 95% confidence intervals (Cls) were estimated for associations between aspirin use and all-cause and prostate cancer-specific mortality. Associations between prescribed dose and dosing intensity were examined. The presence of effect modification by the type of treatment received and tumour characteristics was also assessed. %26lt;br%26gt;Results: Two thousand nine hundred and thirty-six men with a diagnosis of stage I-II prostate cancer (2001-2006) were identified (aspirin users, n = 1131). The median duration of patient follow-up was 5.5 years. In adjusted analyses, aspirin use was associated with a small, but non-significant, reduced risk of prostate cancer-specific mortality (HR = 0.88, 95% Cl 0.67-1.15). In dose-response analyses, stronger associations with prostate cancer-specific mortality were observed in men with higher aspirin dosing intensity (HR 0.73, 95% Cl 0.51-1.05) and in men receiving %26gt;75 mg of aspirin (HR - 0.61, 9500 Cl 0.37-0.99). Analyses of effect modification by treatment type or tumour characteristics were non-significant. %26lt;br%26gt;Conclusions: Consistent with prior studies, aspirin usc was associated with a non significant reduccd risk of prostate cancer-specific modality in men with localised prostate cancer. Men receiving higher doses of aspirin had a statistically significant reduced risk of prostate cancer-specific mortality. These findings regarding an aspirin dose require further investigation.

• 出版日期2014-1