BACKGROUND: Cyclooxygenes-2 overexpression may contribute to colorectal cancer (CRC) occurrence. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) can reduce CRC 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 CRC incidence in Taiwan. METHODS: A nested case-control study was conducted using the National Health Insurance Research Database in Taiwan. We identified patients with a diagnosis of CRC from 2005 to 2013 in the Registry of Catastrophic Illness Patient Database. We selected patients without CRC 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 CRC. RESULTS: A total of 65,208 CRC cases and 65,208 matched controls were identified. Patients with aspirin use had a lower risk of CRC compared to non-users (adjusted odds ratio (AOR)=0.94, 95% confidence interval (CI)=0.90-0.99). NSAID use was associated with a lower incidence of CRC (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 CRC, but no dose-response effects were noted. CONCLUSIONS: Aspirin and NSAIDs were associated with a reduced risk of CRC development among a study cohort in an Asian population. IMPACT: This study provided a possible chemoprevention for CRC in an Asian population.
Date:
2018-07
Relation:
Cancer Epidemiology, Biomarkers and Prevention. 2018 Jul;27(7):737-745.
