Aspirin use may prolong survival for older patients with bladder, breast cancers
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Any aspirin use and aspirin use at least three times per week appeared associated with improvements in survival outcomes among older adults with bladder and breast cancers, according to study results published in JAMA Network Open.
However, researchers did not observe a survival benefit among patients with esophageal, gastric, pancreatic or uterine cancers, nor did they observe an association between aspirin use and incidence of any of the investigated cancer types.
“We previously evaluated the association between aspirin use and risk [for] mortality from all causes, cancer and colorectal cancer in the Prostate, Lung, Colorectal and Ovarian [PLCO] Cancer Screening Trial, with interesting results. We therefore wanted to expand our evaluation to other cancers in the trial,” Holli A. Loomans-Kropp, PhD, MPH, researcher in the division of cancer prevention at the NCI, told Healio.
Limited data exist regarding the impact of long-term aspirin use on cancer incidence and survival among older adults.
For the post-hoc analysis of the PLCO Cancer Screening Trial — which included adults aged 55 to 74 years from 10 screening centers between Nov. 8, 1993, and July 2, 2001 — researchers pooled data on 139,896 adults (mean age at baseline, 66.4 years; 51.4% women; 88.5% white) to assess the association between aspirin use and new cancer risk. They also assessed site-specific cancer-associated survival for bladder, breast, esophageal, gastric, pancreatic and uterine cancers.
Overall, 32,580 incident cancers were reported during the study period, including breast (14%), bladder (5.4%), pancreatic (2.7%), uterine (2.2%), gastric (1.2%) and esophageal (1%) cancers.
Results of analyses that evaluated aspirin use and cancer incidence showed aspirin use at least three times per week did not appear associated with reduced risk for bladder (HR = 0.99; 95% CI, 0.9-1.1), breast (HR = 0.99; 95% CI, 0.93-1.05), pancreatic (HR = 0.94; 95% CI, 0.81-1.08), uterine (HR = 0.9; 95% CI, 0.76-1.06), esophageal (HR = 0.88; 95% CI, 0.7-1.11) or gastric (HR = 0.84; 95% CI, 0.68-1.04) cancers.
However, such use appeared associated with prolonged survival among patients with bladder (HR = 0.67; 95% CI, 0.51-0.88) and breast (HR = 0.75; 95% CI, 0.59-0.96) cancers, multivariable regression analysis showed. In addition, researchers observed a survival benefit with any aspirin use among patients with bladder (HR = 0.75; 95% CI, 0.58-0.98) and breast (HR = 0.79; 95% CI, 0.63-0.99) cancers.
Aspirin use did not appear associated with longer survival among patients with esophageal, gastric, pancreatic or uterine cancers.
Limitations of the study included the fact that it was a secondary analysis of a cancer screening trial and the exposure and outcomes of interest were not the primary designated study outcomes, researchers noted.
“The results of this study are not able to inform clinical practice or patient recommendations,” Loomans-Kropp said. “Conducting a prospective, randomized trial investigating these outcomes would provide better evidence to potentially inform clinical practice.”
For more information:
Holli A. Loomans-Kropp, PhD, MPH, can be reached at NCI, 9609 Medical Center Drive, Room 5E232, Rockville, MD 20850; email: holli.loomans@nih.gov.
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