The effect of aspirin and nonsteroidal anti inflammatory drug use after diagnosis on survival of oesophageal cancer patients
Background:Aspirin use has been shown to lower incidence and mortality in cancer patients. The aim of this population based study was to determine the effect of postdiagnosis low dose aspirin use on survival of patients with oesophageal cancer.Methods:Patients with oesophageal cancer (1998 2010) were selected from the Eindhoven Cancer Registry and linked with outpatient pharmacy data regarding aspirin and nonsteroidal anti inflammatory drugs (NSAIDs) Users were subdivided into both prediagnosis and postdiagnosis or only postdiagnosis users. Parametric survival models with an exponential (Poisson) distribution were used with non specific death as endpoint.Results:In this study 560 patients were included. Overall, 157 patients (28.0% were non users, 293 patients (52.3% pre and postdiagnosis (89 aspirin and 204 NSAID users) and 110 patients (19.6% only postdiagnosis users (16 aspirin and 94 NSAID users) Postdiagnosis aspirin use was associated with overall survival (RR 0.45 (95% CI 0.34 0.60; P<0.001) adjusted rate ratio was 0.42 (95% CI: 0.30 0.57; P<0.001) Postdiagnosis use of NSAIDs was associated with overall survival (RR 0.61 (95% CI 0.49 0.76; <0.001) however, adjusted analyses did not show a significant association with a rate ratio of 0.84 (95% CI 0.66 1.07; P=0.2).Conclusions:Our study shows that postdiagnosis aspirin use might be associated with a higher survival rate in oesophageal cancer patients. A randomised clinical trial is needed to verify our observations of possible postdiagnosis aspirin use benefit.
British Journal of Cancer