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Aspirin regimen increased survival in elderly patients with colon cancer
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Elderly patients who began an aspirin regimen after being diagnosed with colon cancer had improved survival compared with nonusers in a recent study.
In a retrospective cohort study, researchers evaluated 536 patients aged 70 years and older with colon cancer. Twenty percent of patients had begun a low-dose (80 mg) aspirin regimen after colon cancer diagnosis — the remaining patients were classified as nonusers — with follow-up from 30 days after diagnosis to either death or the last contact date.
Aspirin users were significantly younger (mean age 76.6 years vs. 77.8; P=.04), and were more likely to undergo surgery than nonusers (98.1% of cases vs. 83.4%; P<.01). Stage I cancer was more common among aspirin users (23.4% of cases vs.14.9%), while more nonusers were diagnosed with stage IV cancer (19.3% vs. 1.9%) (P<.01 for both).
Death occurred in 63.2% of cases between 1998 and 2007. Multivariate analysis adjusting for factors including age, sex, cancer stage, grade and location of tumor, year of diagnosis, use of adjuvant chemotherapy, presence of comorbidities and whether surgery was performed indicated an association between aspirin use after diagnosis and longer survival (adjusted RR=0.59; 95% CI, 0.44-0.81).
After stratification according to the above factors, investigators found the association most pronounced in patients with higher stage and grade of cancer who did not undergo chemotherapy (aRR=0.71, 0.64-0.79). Further stratification according to comorbidities indicated associations between aspirin use and survival in patients with diabetes (aRR=0.53, 0.32-0.86) and without pulmonary disease (aRR=0.72, 0.64-0.80), as well as with (aRR=0.69, 0.59-0.79) and without cardiovascular disease (aRR=0.77, 0.66-0.89) (95% CI for all).
“Elderly adults are a frequently overlooked, understudied and often undertreated group of individuals,” the researchers wrote. “These findings may have important clinical implications in older adults with colorectal cancer.
“In this study, aspirin emerges as an effective adjuvant agent, increasing overall survival in older adults with colon cancer, although a randomized trial in this age group is necessary to confirm the therapeutic role of aspirin and is currently being developed in the Netherlands.”
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