Can aspirin reduce the risk of colorectal cancer in people with diabetes? A population-based cohort study
Resource
Diabetic Med., 32(3), 324-331
Journal
Diabetic Medicine
Date Issued
2014
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. ? 2014 Diabetes UK.
SDGs
Other Subjects
acetylsalicylic acid; insulin; oral antidiabetic agent; acetylsalicylic acid; antidiabetic agent; nonsteroid antiinflammatory agent; acquired immune deficiency syndrome; adult; Article; cancer mortality; cancer prevention; cancer risk; cerebrovascular disease; cohort analysis; colorectal cancer; comorbidity; congestive heart failure; diabetes mellitus; diabetic patient; drug use; female; health insurance; heart infarction; hepatitis B; hepatitis C; hospitalization; human; insulin treatment; liver disease; low drug dose; major clinical study; male; national health insurance; peripheral vascular disease; retrospective study; risk assessment; risk reduction; senescence; sensitivity analysis; treatment duration; aged; Colorectal Neoplasms; complication; diabetes mellitus; dose response; longitudinal study; middle aged; prevalence; proportional hazards model; risk factor; Taiwan; time; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Cohort Studies; Colorectal Neoplasms; Diabetes Complications; Diabetes Mellitus; Dose-Response Relationship, Drug; Female; Humans; Hypoglycemic Agents; Longitudinal Studies; Male; Middle Aged; Prevalence; Proportional Hazards Models; Retrospective Studies; Risk Factors; Taiwan; Time Factors
Type
journal article