Can aspirin reduce the risk of colorectal cancer in people with diabetes?

A population-based cohort study

Cheng-Ching Lin, M S Lai, W Y Shau

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

AIM: To evaluate whether aspirin can reduce the risk of colorectal cancer in people with diabetes.

METHODS: We studied ≥ 30-year-old people with diabetes, included in the Longitudinal Health Insurance Database 2005 in Taiwan, who were treated with hypoglycaemic drugs. We used a time-varying Cox regression model to adjust for immortal time bias and to estimate the adjusted hazard ratio and 95% CI for the association between aspirin use and colorectal cancer occurrence.

RESULTS: We studied a total of 60 828 people with diabetes (31 176 men and 29 652 women). Their mean (sd) age was 58.72 (13.33) years. A total of 26 494 people were taking aspirin. Aspirin use 3-5 times/week (moderate frequency) for > 5 years (long duration) was found to reduce the risk of colorectal cancer by 46% (hazard ratio 0.54, 95% CI 0.34-0.86). Aspirin use > 5 times/week (high frequency) for 4-5 years (moderate duration) and > 5 years reduced the risk of colorectal cancer by 56 and 68%, respectively (hazard ratio 0.44, 95% CI 0.24-0.80; hazard ratio 0.32, 95% CI 0.20-0.50). Low frequency (≤ 2 times/week) and/or short duration (≤ 3 years) of aspirin use did not reduce the risk of colorectal cancer.

CONCLUSIONS: Aspirin use with high frequency and long duration reduced the risk of colorectal cancer in people with diabetes in a frequency- and duration-dependent manner, whereas low frequency and/or short duration of aspirin use did not. The dosage, frequency and duration of aspirin use that are sufficient to prevent the incidence of colorectal cancer in people with diabetes require further study.

Original languageEnglish
Pages (from-to)324-31
Number of pages8
JournalDiabetic Medicine
Volume32
Issue number3
DOIs
Publication statusPublished - Mar 2015

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Aspirin
Colorectal Neoplasms
Cohort Studies
Population
Health Insurance
Taiwan
Proportional Hazards Models
Hypoglycemic Agents
Databases
Incidence

Keywords

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
  • Aspirin/therapeutic use
  • Cohort Studies
  • Colorectal Neoplasms/epidemiology
  • Diabetes Complications/complications
  • Diabetes Mellitus/drug therapy
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hypoglycemic Agents/therapeutic use
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Taiwan/epidemiology
  • Time Factors

Cite this

Can aspirin reduce the risk of colorectal cancer in people with diabetes? A population-based cohort study. / Lin, Cheng-Ching; Lai, M S; Shau, W Y.

In: Diabetic Medicine, Vol. 32, No. 3, 03.2015, p. 324-31.

Research output: Contribution to journalArticle

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title = "Can aspirin reduce the risk of colorectal cancer in people with diabetes?: A population-based cohort study",
abstract = "AIM: To evaluate whether aspirin can reduce the risk of colorectal cancer in people with diabetes.METHODS: We studied ≥ 30-year-old people with diabetes, included in the Longitudinal Health Insurance Database 2005 in Taiwan, who were treated with hypoglycaemic drugs. We used a time-varying Cox regression model to adjust for immortal time bias and to estimate the adjusted hazard ratio and 95{\%} CI for the association between aspirin use and colorectal cancer occurrence.RESULTS: We studied a total of 60 828 people with diabetes (31 176 men and 29 652 women). Their mean (sd) age was 58.72 (13.33) years. A total of 26 494 people were taking aspirin. Aspirin use 3-5 times/week (moderate frequency) for > 5 years (long duration) was found to reduce the risk of colorectal cancer by 46{\%} (hazard ratio 0.54, 95{\%} CI 0.34-0.86). Aspirin use > 5 times/week (high frequency) for 4-5 years (moderate duration) and > 5 years reduced the risk of colorectal cancer by 56 and 68{\%}, respectively (hazard ratio 0.44, 95{\%} CI 0.24-0.80; hazard ratio 0.32, 95{\%} CI 0.20-0.50). Low frequency (≤ 2 times/week) and/or short duration (≤ 3 years) of aspirin use did not reduce the risk of colorectal cancer.CONCLUSIONS: Aspirin use with high frequency and long duration reduced the risk of colorectal cancer in people with diabetes in a frequency- and duration-dependent manner, whereas low frequency and/or short duration of aspirin use did not. The dosage, frequency and duration of aspirin use that are sufficient to prevent the incidence of colorectal cancer in people with diabetes require further study.",
keywords = "Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Aspirin/therapeutic use, Cohort Studies, Colorectal Neoplasms/epidemiology, Diabetes Complications/complications, Diabetes Mellitus/drug therapy, Dose-Response Relationship, Drug, Female, Humans, Hypoglycemic Agents/therapeutic use, Longitudinal Studies, Male, Middle Aged, Prevalence, Proportional Hazards Models, Retrospective Studies, Risk Factors, Taiwan/epidemiology, Time Factors",
author = "Cheng-Ching Lin and Lai, {M S} and Shau, {W Y}",
note = "{\circledC} 2014 The Authors. Diabetic Medicine {\circledC} 2014 Diabetes UK.",
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TY - JOUR

T1 - Can aspirin reduce the risk of colorectal cancer in people with diabetes?

T2 - A population-based cohort study

AU - Lin, Cheng-Ching

AU - Lai, M S

AU - Shau, W Y

N1 - © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

PY - 2015/3

Y1 - 2015/3

N2 - AIM: To evaluate whether aspirin can reduce the risk of colorectal cancer in people with diabetes.METHODS: We studied ≥ 30-year-old people with diabetes, included in the Longitudinal Health Insurance Database 2005 in Taiwan, who were treated with hypoglycaemic drugs. We used a time-varying Cox regression model to adjust for immortal time bias and to estimate the adjusted hazard ratio and 95% CI for the association between aspirin use and colorectal cancer occurrence.RESULTS: We studied a total of 60 828 people with diabetes (31 176 men and 29 652 women). Their mean (sd) age was 58.72 (13.33) years. A total of 26 494 people were taking aspirin. Aspirin use 3-5 times/week (moderate frequency) for > 5 years (long duration) was found to reduce the risk of colorectal cancer by 46% (hazard ratio 0.54, 95% CI 0.34-0.86). Aspirin use > 5 times/week (high frequency) for 4-5 years (moderate duration) and > 5 years reduced the risk of colorectal cancer by 56 and 68%, respectively (hazard ratio 0.44, 95% CI 0.24-0.80; hazard ratio 0.32, 95% CI 0.20-0.50). Low frequency (≤ 2 times/week) and/or short duration (≤ 3 years) of aspirin use did not reduce the risk of colorectal cancer.CONCLUSIONS: Aspirin use with high frequency and long duration reduced the risk of colorectal cancer in people with diabetes in a frequency- and duration-dependent manner, whereas low frequency and/or short duration of aspirin use did not. The dosage, frequency and duration of aspirin use that are sufficient to prevent the incidence of colorectal cancer in people with diabetes require further study.

AB - AIM: To evaluate whether aspirin can reduce the risk of colorectal cancer in people with diabetes.METHODS: We studied ≥ 30-year-old people with diabetes, included in the Longitudinal Health Insurance Database 2005 in Taiwan, who were treated with hypoglycaemic drugs. We used a time-varying Cox regression model to adjust for immortal time bias and to estimate the adjusted hazard ratio and 95% CI for the association between aspirin use and colorectal cancer occurrence.RESULTS: We studied a total of 60 828 people with diabetes (31 176 men and 29 652 women). Their mean (sd) age was 58.72 (13.33) years. A total of 26 494 people were taking aspirin. Aspirin use 3-5 times/week (moderate frequency) for > 5 years (long duration) was found to reduce the risk of colorectal cancer by 46% (hazard ratio 0.54, 95% CI 0.34-0.86). Aspirin use > 5 times/week (high frequency) for 4-5 years (moderate duration) and > 5 years reduced the risk of colorectal cancer by 56 and 68%, respectively (hazard ratio 0.44, 95% CI 0.24-0.80; hazard ratio 0.32, 95% CI 0.20-0.50). Low frequency (≤ 2 times/week) and/or short duration (≤ 3 years) of aspirin use did not reduce the risk of colorectal cancer.CONCLUSIONS: Aspirin use with high frequency and long duration reduced the risk of colorectal cancer in people with diabetes in a frequency- and duration-dependent manner, whereas low frequency and/or short duration of aspirin use did not. The dosage, frequency and duration of aspirin use that are sufficient to prevent the incidence of colorectal cancer in people with diabetes require further study.

KW - Adult

KW - Aged

KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use

KW - Aspirin/therapeutic use

KW - Cohort Studies

KW - Colorectal Neoplasms/epidemiology

KW - Diabetes Complications/complications

KW - Diabetes Mellitus/drug therapy

KW - Dose-Response Relationship, Drug

KW - Female

KW - Humans

KW - Hypoglycemic Agents/therapeutic use

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Proportional Hazards Models

KW - Retrospective Studies

KW - Risk Factors

KW - Taiwan/epidemiology

KW - Time Factors

U2 - 10.1111/dme.12596

DO - 10.1111/dme.12596

M3 - Article

VL - 32

SP - 324

EP - 331

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 3

ER -