BACKGROUND: Low-dose aspirin and metformin have been individually associated with a reduced risk of cancer. Whether their concurrent use in adults with type 2 diabetes mellitus (T2DM) is associated with a reduced risk of colorectal cancer (CRC) is unclear.
OBJECTIVE: Among individuals with T2DM taking metformin, we sought to evaluate the association between low-dose aspirin versus no aspirin and the risk of CRC.
METHODS: A multiple-database new-user cohort study of patients with T2DM taking metformin was conducted between 2007-2010 (Clinical Data Analysis and Reporting System [CDARS], Hong Kong) and 2007-2016 (The Health Improvement Network [THIN], UK). The primary outcome was incident CRC. Patients were followed from index date of prescription until the earliest occurrence of an outcome of interest, an incident diagnosis of any cancer, death, or until December 31, 2019. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Estimates were pooled using an inverse variance random effects model, and heterogeneity was assessed using I(2) .
RESULTS: After one-to-one propensity-score matching, 57,534 patients were included (CDARS = 16,276; THIN = 41,258). The median (IQR) follow-up was 9.3 (6.5-10.7) years in CDARS and 3.2 (1.1-5.8) years in THIN. The concurrent use of low-dose aspirin and metformin was not associated with a lower risk of CRC compared to metformin only (HR = 0.89, 95% CI 0.75-1.05, I(2) = 0%).
CONCLUSION: Low-dose aspirin was not associated with a lower risk of CRC in patients with T2DM taking metformin. Our study does not support the routine use of low-dose aspirin in this population. This article is protected by copyright. All rights reserved.
|ジャーナル名||Journal of internal medicine|
|投稿者||Shami, Jessica Jp; Yan, Vincent Kc; Wei, Yue; Alwafi, Hassan; Blais, Joseph E; Wan, Eric; Wong, Carlos Kh; Cheung, Ka Shing; Leung, Wai K; Wong, Martin Cs; Wong, Ian Ck; Chan, Esther W|
|組織名||Centre for Safe Medication Practice and Research, Department of Pharmacology and;Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong;Kong.;Faculty of Medicine, Umm Alqura University, Mecca, Saudi Arabia.;Alnoor Specialist Hospital, Mecca, Saudi Arabia.;Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS;Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.;Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology;Park, Sha Tin, Hong Kong.;Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong;Kong, Hong Kong.;Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen,;China.;Jockey Club School of Public Health and Primary Care, The Chinese University of;Hong Kong, Hong Kong, Hong Kong.;Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.|