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Article: Nonsteroidal anti-inflammatory drugs but not aspirin are associated with a lower risk of post-colonoscopy colorectal cancer
Title | Nonsteroidal anti-inflammatory drugs but not aspirin are associated with a lower risk of post-colonoscopy colorectal cancer |
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Authors | |
Keywords | adenocarcinoma colon cancer interval cancer NSAID post‐colonoscopy colorectal cancer |
Issue Date | 2020 |
Publisher | Wiley-Blackwell. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2036 |
Citation | Alimentary Pharmacology and Therapeutics, 2020, v. 51 n. 9, p. 899-908 How to Cite? |
Abstract | Background:
Although nonsteroidal anti‐inflammatory drugs (NSAIDs) reduce colorectal cancer (CRC) risk, their role in preventing post‐colonoscopy CRC (PCCRC) remains undetermined.
Aims:
To investigate whether NSAIDs reduce PCCRC risk after a negative baseline colonoscopy
Methods:
This is a retrospective cohort study based on a territory‐wide healthcare database of Hong Kong. All patients (aged 40 or above) who underwent colonoscopies between 2005 and 2013 were identified. Exclusion criteria included CRC detected within 6 months of index colonoscopy, prior CRC, inflammatory bowel disease and prior colectomy. The primary outcome was PCCRC‐3y diagnosed between 6 and 36 months after index colonoscopy. Sites of CRC were categorised as proximal (proximal to splenic flexure) and distal. The adjusted hazards ratio (aHR) of PCCRC‐3y with NSAID and aspirin use (defined as cumulative use for ≥90 days within 5 years before index colonoscopy) was derived by propensity score (PS) regression adjustment of 22 covariates (including patient factors, concurrent medication use and endoscopy centre's performance).
Results:
Of 187 897 eligible patients, 21 757 (11.6%) were NSAID users. 854 (0.45%) developed PCCRC‐3y (proximal cancer: 147 [17.2%]). NSAIDs were associated with a lower PCCRC‐3y risk (aHR: 0.54, 95% CI: 0.41‐0.70), but not CRC that developed >3 years (aHR: 0.78, 95% CI 0.56‐1.09). The aHR was 0.48 (95% CI: 0.24‐0.95) for proximal and 0.55 (95% CI: 0.40‐0.74) for distal cancer. A duration‐ and frequency response relationship was observed (Ptrend < 0.001). For aspirin, the aHR was 1.01 (95% CI: 0.80‐1.28).
Conclusions:
Non‐aspirin NSAIDs were associated with lower PCCRC risk after a negative baseline colonoscopy. |
Persistent Identifier | http://hdl.handle.net/10722/281807 |
ISSN | 2023 Impact Factor: 6.6 2023 SCImago Journal Rankings: 2.794 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KS | - |
dc.contributor.author | Chen, L | - |
dc.contributor.author | Chan, EW | - |
dc.contributor.author | Seto, WK | - |
dc.contributor.author | Wong, ICK | - |
dc.contributor.author | Leung, WK | - |
dc.date.accessioned | 2020-03-27T04:22:44Z | - |
dc.date.available | 2020-03-27T04:22:44Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Alimentary Pharmacology and Therapeutics, 2020, v. 51 n. 9, p. 899-908 | - |
dc.identifier.issn | 0269-2813 | - |
dc.identifier.uri | http://hdl.handle.net/10722/281807 | - |
dc.description.abstract | Background: Although nonsteroidal anti‐inflammatory drugs (NSAIDs) reduce colorectal cancer (CRC) risk, their role in preventing post‐colonoscopy CRC (PCCRC) remains undetermined. Aims: To investigate whether NSAIDs reduce PCCRC risk after a negative baseline colonoscopy Methods: This is a retrospective cohort study based on a territory‐wide healthcare database of Hong Kong. All patients (aged 40 or above) who underwent colonoscopies between 2005 and 2013 were identified. Exclusion criteria included CRC detected within 6 months of index colonoscopy, prior CRC, inflammatory bowel disease and prior colectomy. The primary outcome was PCCRC‐3y diagnosed between 6 and 36 months after index colonoscopy. Sites of CRC were categorised as proximal (proximal to splenic flexure) and distal. The adjusted hazards ratio (aHR) of PCCRC‐3y with NSAID and aspirin use (defined as cumulative use for ≥90 days within 5 years before index colonoscopy) was derived by propensity score (PS) regression adjustment of 22 covariates (including patient factors, concurrent medication use and endoscopy centre's performance). Results: Of 187 897 eligible patients, 21 757 (11.6%) were NSAID users. 854 (0.45%) developed PCCRC‐3y (proximal cancer: 147 [17.2%]). NSAIDs were associated with a lower PCCRC‐3y risk (aHR: 0.54, 95% CI: 0.41‐0.70), but not CRC that developed >3 years (aHR: 0.78, 95% CI 0.56‐1.09). The aHR was 0.48 (95% CI: 0.24‐0.95) for proximal and 0.55 (95% CI: 0.40‐0.74) for distal cancer. A duration‐ and frequency response relationship was observed (Ptrend < 0.001). For aspirin, the aHR was 1.01 (95% CI: 0.80‐1.28). Conclusions: Non‐aspirin NSAIDs were associated with lower PCCRC risk after a negative baseline colonoscopy. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2036 | - |
dc.relation.ispartof | Alimentary Pharmacology and Therapeutics | - |
dc.rights | Preprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. | - |
dc.subject | adenocarcinoma | - |
dc.subject | colon cancer | - |
dc.subject | interval cancer | - |
dc.subject | NSAID | - |
dc.subject | post‐colonoscopy colorectal cancer | - |
dc.title | Nonsteroidal anti-inflammatory drugs but not aspirin are associated with a lower risk of post-colonoscopy colorectal cancer | - |
dc.type | Article | - |
dc.identifier.email | Cheung, KS: cks634@hku.hk | - |
dc.identifier.email | Chen, L: equalclj@hku.hk | - |
dc.identifier.email | Chan, EW: ewchan@hku.hk | - |
dc.identifier.email | Seto, WK: wkseto@hku.hk | - |
dc.identifier.email | Wong, ICK: wongick@hku.hk | - |
dc.identifier.email | Leung, WK: waikleung@hku.hk | - |
dc.identifier.authority | Cheung, KS=rp02532 | - |
dc.identifier.authority | Chan, EW=rp01587 | - |
dc.identifier.authority | Seto, WK=rp01659 | - |
dc.identifier.authority | Wong, ICK=rp01480 | - |
dc.identifier.authority | Leung, WK=rp01479 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1111/apt.15693 | - |
dc.identifier.scopus | eid_2-s2.0-85082056890 | - |
dc.identifier.hkuros | 309579 | - |
dc.identifier.volume | 51 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 899 | - |
dc.identifier.epage | 908 | - |
dc.identifier.isi | WOS:000520884500001 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0269-2813 | - |