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Aspirin, NSAIDs not linked to pancreatic cancer risk
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Investigators found no evidence that regular use of aspirin or NSAIDs increases the risk for pancreatic cancer in a recent study.
However, regular aspirin use appeared to protect against pancreatic cancer in a subset of patients with diabetes, prompting the study authors to call for further research on this observed effect.
“Regular aspirin or non-aspirin NSAID use was not associated with future risk of pancreatic cancer in participants from several large prospective cohort studies,” Natalia Khalaf, MD, of the division of gastroenterology, hepatology and endoscopy at Brigham and Women’s Hospital in Boston, told Healio Gastroenterology and Liver Disease. “However, among people with diabetes, regular aspirin use was associated with a 30% decreased risk of pancreatic cancer, and this association was primarily seen in those with higher baseline levels of systemic inflammation, as reflected by inflammatory dietary patterns.”
While previous data has shown aspirin and NSAID use protects against certain cancers, their effects on pancreatic cancer risk remain unclear. This prompted Khalaf and colleagues to analyze data on regular use of these drugs and pancreatic adenocarcinoma incidence among 141,940 participants from the Health Professionals Follow-up Study (1986-2012) and the Nurses’ Health Study (1980-2012).
Over 4.2 million person-years of follow-up, 1,122 participants developed pancreatic adenocarcinoma.
Khalaf and colleagues found no associations between aspirin or NSAID use and pancreatic cancer risk, “even after considering several latency exposure classifications,” she said.
Notably, a pre-planned subgroup analysis revealed that participants with diabetes who used aspirin regularly showed a lower risk for pancreatic cancer (RR = 0.71; 95% CI, 0.54-0.94).
“To explore whether this reduced risk was related to aspirin’s anti-inflammatory properties, we conducted stratified analysis by empirical dietary inflammatory pattern score, which is a surrogate marker of systemic inflammation,” Khalaf said.
Patients with diabetes who consumed a high inflammatory diet based on this score showed a lower risk of pancreatic cancer with regular aspirin use (RR = 0.58; 95% CI, 0.37-0.89).
“Although highly exploratory, we noted that regular aspirin use was associated with reduced pancreatic cancer risk primarily among diabetic participants expected to have higher levels of systemic inflammation,” Khalaf said. “The results of this study support that the effects of aspirin on pancreatic tumorigenesis in the setting of diabetes and higher baseline levels of systemic inflammation should be further investigated.”
Additionally, Khalaf and colleagues studied the effects of pre-diagnostic levels of plasma salicylurate, a major aspirin metabolite, among 396 pancreatic cancer cases and 784 matched controls nested in three large prospective cohorts. However, they found no association between plasma salicylurate levels and pancreatic cancer risk. – by Adam Leitenberger
Disclosures: The authors report no relevant financial disclosures.
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