Takeaway
- The use of non-steroidal anti-inflammatory drugs (NSAIDs), but not aspirin, was associated with a reduced risk of post-colonoscopy colorectal cancer (PCCRC) after a negative baseline colonoscopy.
Why this matters
- Findings highlight the potential chemopreventive effects of NSAIDs on the development of CRC according to the timing of NSAID uses and colonoscopy.
Study design
- A retrospective cohort study included 187,897 patients with CRC (aged ≥40 years) who underwent colonoscopies between 2005 and 2013.
- Primary outcome: PCCRC diagnosed between 6 and 36 months (PCCRC-3y).
- Funding: Health and Medical Research Fund, Food and Health Bureau, The Government of the Hong Kong Special Administrative Region.
Key results
- Of 187,897 patients with CRC, 21,757 (11.6%) were NSAID users and 166,140 (88.4%) were NSAID non-users.
- Overall, 854 patients developed PCCRC-3y (distal cancer, 707 [82.8%]; proximal cancer, 147 [17.2%]) with an overall incidence rate of 15.2 per 10,000 person-years.
- NSAID use was associated with an overall lower risk of PCCRC-3y (adjusted HR [aHR], 0.54; 95% CI, 0.41-0.70), but not with PCCRC >3 years (aHR, 0.78; 95% CI, 0.56-1.09).
- In the stratified analysis, NSAID use was associated with a reduction in the risk of proximal (aHR, 0.48; 95% CI, 0.24-0.95) and distal colon (aHR, 0.55; 95% CI, 0.40-0.74) cancers.
- Compared with never user, longer duration vs shorter duration of NSAID use and more frequent (≥weekly) vs infrequent (<weekly) use offered greater protection against PCCRC-3y (Ptrend<.001 for both).
- Aspirin use was not linked to a lower risk of PCCRC-3y (aHR, 1.01; 95% CI, 0.80-1.28).
Limitations
- Data on some of the risk factors for CRC, like family history and lifestyle factors were unavailable
- Retrospective design.
References
References
