Elisabeth Solmunde, Rikke N Pedersen, Mette Nørgaard, Lene Mellemkjær, Søren Friis, Bent Ejlertsen, Thomas P Ahern, Deirdre P Cronin-Fenton
{"title":"低剂量阿司匹林使用与乳腺癌复发之间的关系：一项丹麦全国队列研究，随访长达23年。","authors":"Elisabeth Solmunde, Rikke N Pedersen, Mette Nørgaard, Lene Mellemkjær, Søren Friis, Bent Ejlertsen, Thomas P Ahern, Deirdre P Cronin-Fenton","doi":"10.1038/s41416-025-03112-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The anti-cancer potential of low-dose aspirin in long-term breast cancer (BC) survivors remain unknown. We evaluated the association between low-dose aspirin use and BC recurrence and mortality.</p><p><strong>Methods: </strong>Women ≥40 years diagnosed with stage I-III BC (1996-2004) were identified from the Danish Breast Cancer Group (DBCG) database and information on aspirin use from the Danish Prescription Registry. We ascertained recurrences from DBCG and via a validated algorithm. We plotted cumulative incidences of recurrence and mortality, accounting for competing risks. Using Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CI), employing landmark analyses at 5-, 10-, and 15-year post-diagnosis.</p><p><strong>Results: </strong>Among 20,509 BC survivors, 4527 developed recurrence over 232,441 person-years of follow-up. The 20-year cumulative incidence of recurrence was lower in users (17.8%) than nonusers (22.4%), with similar trends among 10-year disease-free survivors (9.9% vs. 12.7%). We observed reduced HRs of recurrence (adjusted HR<sub>5-year</sub> = 0.80, (95% CI = 0.66-0.98); HR<sub>10-year</sub> = 0.87 (0.73-1.05); HR<sub>15-year</sub> = 0.82 (0.57-1.17) in aspirin users, but increased HRs of all-cause mortality (HR<sub>5-year</sub> = 1.08 (0.96-1.21); HR<sub>10-year</sub> = 1.09 (0.96-1.24); HR<sub>15-year</sub> = 1.09 (0.80-1.31).</p><p><strong>Conclusions: </strong>The reduced recurrence risk in aspirin users may indicate potential anti-cancer effects of aspirin, though the increased risk of death suggests influence by confounding by indication and competing risks.</p>","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":6.8000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between low-dose aspirin use and breast cancer recurrence: a Danish nationwide cohort study with up to 23 years of follow-up.\",\"authors\":\"Elisabeth Solmunde, Rikke N Pedersen, Mette Nørgaard, Lene Mellemkjær, Søren Friis, Bent Ejlertsen, Thomas P Ahern, Deirdre P Cronin-Fenton\",\"doi\":\"10.1038/s41416-025-03112-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The anti-cancer potential of low-dose aspirin in long-term breast cancer (BC) survivors remain unknown. We evaluated the association between low-dose aspirin use and BC recurrence and mortality.</p><p><strong>Methods: </strong>Women ≥40 years diagnosed with stage I-III BC (1996-2004) were identified from the Danish Breast Cancer Group (DBCG) database and information on aspirin use from the Danish Prescription Registry. We ascertained recurrences from DBCG and via a validated algorithm. We plotted cumulative incidences of recurrence and mortality, accounting for competing risks. Using Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CI), employing landmark analyses at 5-, 10-, and 15-year post-diagnosis.</p><p><strong>Results: </strong>Among 20,509 BC survivors, 4527 developed recurrence over 232,441 person-years of follow-up. The 20-year cumulative incidence of recurrence was lower in users (17.8%) than nonusers (22.4%), with similar trends among 10-year disease-free survivors (9.9% vs. 12.7%). We observed reduced HRs of recurrence (adjusted HR<sub>5-year</sub> = 0.80, (95% CI = 0.66-0.98); HR<sub>10-year</sub> = 0.87 (0.73-1.05); HR<sub>15-year</sub> = 0.82 (0.57-1.17) in aspirin users, but increased HRs of all-cause mortality (HR<sub>5-year</sub> = 1.08 (0.96-1.21); HR<sub>10-year</sub> = 1.09 (0.96-1.24); HR<sub>15-year</sub> = 1.09 (0.80-1.31).</p><p><strong>Conclusions: </strong>The reduced recurrence risk in aspirin users may indicate potential anti-cancer effects of aspirin, though the increased risk of death suggests influence by confounding by indication and competing risks.</p>\",\"PeriodicalId\":9243,\"journal\":{\"name\":\"British Journal of Cancer\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.8000,\"publicationDate\":\"2025-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1038/s41416-025-03112-3\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41416-025-03112-3","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Association between low-dose aspirin use and breast cancer recurrence: a Danish nationwide cohort study with up to 23 years of follow-up.
Background: The anti-cancer potential of low-dose aspirin in long-term breast cancer (BC) survivors remain unknown. We evaluated the association between low-dose aspirin use and BC recurrence and mortality.
Methods: Women ≥40 years diagnosed with stage I-III BC (1996-2004) were identified from the Danish Breast Cancer Group (DBCG) database and information on aspirin use from the Danish Prescription Registry. We ascertained recurrences from DBCG and via a validated algorithm. We plotted cumulative incidences of recurrence and mortality, accounting for competing risks. Using Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CI), employing landmark analyses at 5-, 10-, and 15-year post-diagnosis.
Results: Among 20,509 BC survivors, 4527 developed recurrence over 232,441 person-years of follow-up. The 20-year cumulative incidence of recurrence was lower in users (17.8%) than nonusers (22.4%), with similar trends among 10-year disease-free survivors (9.9% vs. 12.7%). We observed reduced HRs of recurrence (adjusted HR5-year = 0.80, (95% CI = 0.66-0.98); HR10-year = 0.87 (0.73-1.05); HR15-year = 0.82 (0.57-1.17) in aspirin users, but increased HRs of all-cause mortality (HR5-year = 1.08 (0.96-1.21); HR10-year = 1.09 (0.96-1.24); HR15-year = 1.09 (0.80-1.31).
Conclusions: The reduced recurrence risk in aspirin users may indicate potential anti-cancer effects of aspirin, though the increased risk of death suggests influence by confounding by indication and competing risks.
期刊介绍：
The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.
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