Aspirin Use Improves Survival in elderly with Bladder or Breast Cancer: JAMA

The aspirin use, nonselectively inhibits cyclooxygenase, thus suppressing inflammation, it stands to reason that long-term aspirin use may affect cancer initiation. Recent large-scale evaluations have indicated aberrant immune cell activity in several tumor types, including bladder, breast, gastric, and uterine tumors, providing a prime target for aspirin activity. Furthermore, aspirin use has been demonstrated to affect survival after a cancer diagnosis, although the data remain mixed. Many studies have evaluated the long-term benefits of aspirin use; however, the association of aspirin use with cancer incidence and survival in older individuals remains uncertain. Additional population-based evidence of this association is necessary to better understand any possible protective effects of aspirin in older adults. Therefore, researchers of the National Cancer Institute, Maryland conducted a study to investigate the association of aspirin use with risk of developing new cancers and site-specific cancer-associated survival in bladder, breast, esophageal, gastric, pancreatic, and uterine cancers.

It was a post hoc analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial. Researchers included a total of 1,39,896 participants who were aged 65 years or older at baseline (1993-2001) or reached age 65 during follow-up. They analyzed the data from January to June 2020. The major outcome assessed was the incidence of and survival from the investigated cancer types. They used Cox proportional hazards regression model to calculate the Univariable and multivariable hazard ratios (HRs) and 95% Confidence intervals by adjusting for covariates.

Key findings of the study were:

• Among 1,39,896 participants, researchers noted 5.4% had bladder, 14.0% breast, 1.0% esophageal, 1.2% gastric, 2.7% pancreatic, and 2.2% uterine cancer (other cancers were excluded).

• They found that aspirin use was not associated with the incidence of any of the investigated cancer types among individuals aged 65 years or older.

• Upon regression analysis, they found that aspirin use at least 3 times/week was associated with increased survival among patients with bladder (HR, 0.67) and breast (HR, 0.75) cancers but not among those with esophageal, gastric, pancreatic, or uterine cancer.

• They also found a similar association in any aspirin use with bladder (HR, 0.75) and breast (HR, 0.79) cancer survival rate.

The authors concluded, "In the current study, any aspirin use and aspirin use at least 3 times/week was associated with improved bladder and breast cancer survival. Associations between aspirin use and incidence of any of the investigated cancers or between aspirin use and esophageal, gastric, pancreatic, or uterine cancer survival were not observed".

For further information:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775219