PURPOSE: The association between the use of aspirin and mortality in patients with prostate cancer remains uncertain.
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We determine whether the use of aspirin in patients with prostate cancer is associated with a decreased risk of prostate cancer mortality and all cause mortality.
MATERIALS AND METHODS: Using the United Kingdom National Cancer Data Repository, Clinical Practice Research Datalink and associated databases, we identified a cohort of men with nonmetastatic prostate cancer between 1998 and 2009, followed until 2012. Cox proportional hazards models were used to estimate adjusted HRs with 95% CIs of mortality outcomes associated with post-diagnostic use of aspirin defined as a time-varying exposure. Effect modification by pre-diagnostic aspirin use was also assessed.
RESULTS: The cohort included 11,779 men followed for 5.4 years (SD 2.9). Post-diagnostic aspirin use was associated with an increased risk of prostate cancer mortality (HR 1.46, 95% CI 1.29-1.65) and all cause mortality (HR 1.37, 95% CI 1.26-1.50). These increased risks were restricted to patients initiating aspirin after the prostate cancer diagnosis (HR 1.84, 95% CI 1.59-2.12, and HR 1.70, 95% CI 1.53-1.88, respectively), and not in patients who were already exposed to aspirin before the diagnosis (HR 0.97, 95% CI 0.81-1.16 and HR 0.98, 95% CI 0.87-1.18, respectively).
CONCLUSIONS: The post-diagnostic use of aspirin is not associated with a decreased risk of prostate cancer outcomes. Increased risks were restricted to patients initiating these drugs after their diagnosis, suggesting a noncausal association.
Assayag J, Pollak MN, Azoulay L. Are you the author?
Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Department of Experimental Medicine, McGill University, Montreal, Quebec, Canada; Department of Oncology, McGill University, Montreal, Quebec, Canada.
Reference: J Urol. 2014 Nov 14. pii: S0022-5347(14)04863-0.