Publication
Title
Maintenance use of non-steroidal anti-inflammatory drugs and risk of gastrointestinal cancer in a nationwide population-based cohort study in Sweden
Author
Abstract
Objectives Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are potential candidates for chemoprevention of gastrointestinal cancer. We aimed to assess the association between contemporary NSAID use (>= 180 days) and gastrointestinal cancer. Design Nationwide Swedish population-based cohort study (2005-2012). Setting Sweden Participants All adults exposed to maintenance NSAIDs use (aspirin, n=783 870; unselective NSAIDs, n=566 209, selective cyclo-oxygenase (COX)-2 inhibitors, n=17 948) compared with the Swedish background population of the same age, sex and calendar period. Outcome measures The risk of different gastrointestinal cancer types expressed as standardised incidence ratios (SIR) and 95% CIs, taking into account concurrent proton pump inhibitors (PPIs) and statins usage. Results The SIR for gastrointestinal cancer for aspirin use was 1.02 (95% CI 1.00 to 1.04), with clearly reduced risk for long-term users (SIR=0.31, 95% CI 0.30 to 0.33 for 5.5-7.7 years), but an increased risk for short-term users (SIR=2.77, 95% CI 2.69 to 2.85), and stronger protective effect for low-dose aspirin (SIR=0.86, 95% CI 0.85 to 0.88). Users of non-selective NSAIDs showed an overall decreased risk of gastrointestinal cancer (SIR=0.79, 95% CI 0.77 to 0.82), in particular for cancer of the stomach, colorectum and oesophagus, and the SIRs were further decreased among long-term users. Users of selective COX-2 inhibitors showed a SIR=0.89 (95% CI 0.73 to 1.09) for gastrointestinal cancers. Both aspirin and unselective NSAIDs users who also were using PPIs, had higher risks for all gastrointestinal cancer types; and lower risk if using statins. Conclusion Long-term use of (low-dose) aspirin and nonselective NSAIDs was associated with a decreased risk of all gastrointestinal cancer types.
Language
English
Source (journal)
BMJ open. - London, 2011, currens
Publication
London : BMJ Group , 2018
ISSN
2044-6055
DOI
10.1136/BMJOPEN-2018-021869
Volume/pages
8 :7 (2018) , 11 p.
Article Reference
e021869
ISI
000446181900171
Pubmed ID
29982219
Medium
E-only publicatie
Full text (Publisher's DOI)
Full text (open access)
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Publication type
Subject
External links
Web of Science
Record
Identifier
Creation 01.10.2021
Last edited 26.11.2024
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