TY - JOUR
T1 - Association between nonsteroidal anti-inflammatory drugs and colorectal cancer
T2 - A population-based case-control study
AU - Kuo, Chun Nan
AU - Pan, Jen Jung
AU - Huang, Ya Wen
AU - Tsai, Hui Ju
AU - Chang, Wei Chiao
N1 - Funding Information:
H.-J. Tsai is supported in part by a grant from the National Health Research Institutes (PH-104-PP-14, PH-104-SP-05, PH-104-SP-16, PH-105-SP-05, and PH-105-SP-04 to H.-J. Tsai; MOST105-2628-B-038-001-MY4 to W.-C. Chang). W.-C. Chang is supported by Taipei Medical University (105-5807-002-400). Chun-Nan Kuo is supported by a grant (103-wf-eva-06) from Taipei Municipal Wanfang Hospital (managed by Taipei Medical University).
Publisher Copyright:
© 2018 American Association for Cancer Research.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Background: COX-2 overexpression may contribute to colorectal cancer occurrence. Aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) can reduce colorectal cancer recurrence, but the efficacy of primary prevention in Asian populations is still elusive. Thus, we examined the primary preventive efficacy of aspirin and NSAIDs on colorectal cancer incidence in Taiwan. Methods: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified patients with diagnosis of colorectal cancer from 2005 to 2013 in the Registry of Catastrophic Illness Patient Database. We selected patients without colorectal cancer from the Longitudinal Health Insurance Database as the controls and matched them with cases. NSAID exposure was defined as at least two prescriptions 13 to 48 months prior to the index date. Conditional logistic regression models were performed to evaluate the association between NSAID use and colorectal cancer. Results: A total of 65,208 colorectal cancer cases and 65,208 matched controls were identified. Patients with aspirin use had a lower risk of colorectal cancer compared with nonusers [adjusted OR (AOR) = 0.94, 95% confidence interval (CI) = 0.90-0.99]. NSAID use was associated with lower incidence of colorectal cancer (AOR = 0.96; 95% CI = 0.92-1.00). When examining colon or rectal cancer, similar decreased risks were observed. Patients taking more cumulative days of NSAIDs use tended to experience a more protective effect on colorectal cancer, but no dose-response effects were noted. Conclusions: Aspirin and NSAIDs were associated with a reduced risk of colorectal cancer development among a study cohort in an Asian population. Impact: This study provided a possible chemoprevention for colorectal cancer in an Asian population.
AB - Background: COX-2 overexpression may contribute to colorectal cancer occurrence. Aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) can reduce colorectal cancer recurrence, but the efficacy of primary prevention in Asian populations is still elusive. Thus, we examined the primary preventive efficacy of aspirin and NSAIDs on colorectal cancer incidence in Taiwan. Methods: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified patients with diagnosis of colorectal cancer from 2005 to 2013 in the Registry of Catastrophic Illness Patient Database. We selected patients without colorectal cancer from the Longitudinal Health Insurance Database as the controls and matched them with cases. NSAID exposure was defined as at least two prescriptions 13 to 48 months prior to the index date. Conditional logistic regression models were performed to evaluate the association between NSAID use and colorectal cancer. Results: A total of 65,208 colorectal cancer cases and 65,208 matched controls were identified. Patients with aspirin use had a lower risk of colorectal cancer compared with nonusers [adjusted OR (AOR) = 0.94, 95% confidence interval (CI) = 0.90-0.99]. NSAID use was associated with lower incidence of colorectal cancer (AOR = 0.96; 95% CI = 0.92-1.00). When examining colon or rectal cancer, similar decreased risks were observed. Patients taking more cumulative days of NSAIDs use tended to experience a more protective effect on colorectal cancer, but no dose-response effects were noted. Conclusions: Aspirin and NSAIDs were associated with a reduced risk of colorectal cancer development among a study cohort in an Asian population. Impact: This study provided a possible chemoprevention for colorectal cancer in an Asian population.
UR - http://www.scopus.com/inward/record.url?scp=85049646233&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049646233&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-17-0876
DO - 10.1158/1055-9965.EPI-17-0876
M3 - Article
AN - SCOPUS:85049646233
SN - 1055-9965
VL - 27
SP - 737
EP - 745
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 7
ER -