2570:在前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中,评估老年人使用阿司匹林与癌症发病率和生存率的关系

Holli A. Loomans-Kropp, P. Pinsky, A. Umar
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引用次数: 0

摘要

许多研究已经评估了阿司匹林使用的长期益处,然而阿司匹林使用与老年人癌症发病率和生存率之间的关系仍不确定。为了更好地了解阿司匹林对老年人的任何可能的保护作用,需要更多的流行病学证据来证明这种关联。我们对前列腺、肺、结直肠和卵巢(PLCO)癌症筛查试验进行了事后回顾性分析,调查了65岁及以上患者使用阿司匹林与膀胱癌、乳腺癌、食管癌、胃癌、胰腺癌和子宫癌发病率和生存率的关系。如果PLCO参与者(1)基线年龄在65岁或以上,或在入组后存活到至少65岁,(2)有有效的基线问卷,并填写了完整的阿司匹林使用信息,则将其纳入当前的研究。偶发性癌症被定义为在队列随访期间首次诊断出的癌症。随访时间从随机分组时或参与者65岁时开始,以先发生者为准,一直持续到癌症诊断、参与者死亡或研究随访结束之日。在诊断为上述癌症的参与者中,评估了诊断前阿司匹林使用与随后癌症特异性生存的关系。本分析的随访从诊断时开始,到死亡或研究随访结束时结束。共有154,897人参加了PLCO试验。其中,139,896人(基线时平均[SD]年龄66.4[2.4]岁;女性71884人(51.4%);123,824名非西班牙裔白人(88.5%)被纳入当前的分析。在研究期间,报告了32,580例癌症(包括1,751例膀胱癌,4,552例乳腺癌,332例食管癌,397例胃癌,878例胰腺癌,716例子宫癌)。任何阿司匹林或阿司匹林使用≥3次/周与所调查的任何癌症类型的发病率均无关。然而,多变量回归分析显示阿司匹林≥3次/周与膀胱增加相关(HR, 0.67;95% CI, 0.51-0.88)和乳腺(HR, 0.75;95% CI, 0.59-0.96),但不包括食管、胃、胰腺或子宫肿瘤的特异性生存率。与膀胱有相似的相关性(HR, 0.75;95% CI, 0.58, 0.98)和乳腺(HR, 0.79;95% CI, 0.63, 0.99),观察到任何阿司匹林使用的癌症生存率。总之,任何阿司匹林的使用和阿司匹林使用≥3次/周与改善膀胱癌和乳腺癌的生存相关。目前的研究结果提供了阿司匹林可能改善膀胱癌和乳腺癌患者生存的观察性证据,但还需要进一步的后续研究。引文格式:Holli A. Loomans-Kropp, Paul Pinsky, Asad Umar。在前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中评估老年人使用阿司匹林与癌症发病率和生存率的关系[摘要]。见:美国癌症研究协会2021年年会论文集;2021年4月10日至15日和5月17日至21日。费城(PA): AACR;癌症杂志,2021;81(13 -增刊):摘要第2570期。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abstract 2570: Evaluation of aspirin use with cancer incidence and survival among older adults in the prostate, lung, colorectal, and ovarian cancer screening trial
Many studies have evaluated the long-term benefits of aspirin use, however the association between aspirin use and cancer incidence and survival in older individuals remains uncertain. Additional epidemiologic evidence of this association is necessary to better understand any possible protective effects of aspirin in older adults. We performed a post-hoc retrospective analysis of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, investigating the association of aspirin use with the risk of cancer incidence and survival from bladder, breast, esophageal, gastric, pancreatic, and uterine cancers among individuals age 65 and older. PLCO participants were included in the current study if (1) they were age 65 or over at baseline or survived to at least age 65 after enrollment and (2) had a valid baseline questionnaire with completed aspirin use information. Incident cancers were defined as first cancers diagnosed during cohort follow-up. Follow-up time began at the time of randomization or when the participant turned 65, whichever occurred first, and continued until the date of the cancer diagnosis, participant death, or the end of the study follow-up. Among participants diagnosed with the above incident cancers, the association of aspirin use prior to diagnosis with subsequent cancer-specific survival was evaluated. Follow-up for this analysis began at the time of diagnosis and ended at death or end of study follow-up. A total of 154,897 individuals were enrolled in the PLCO Trial. Of these, 139,896 individuals (mean [SD] age at baseline, 66.4 [2.4] years; 71,884 [51.4%] women; 123,824 white non-Hispanic [88.5%]) were included in the current analysis. During the study period, 32,580 incident cancers (including 1,751 bladder, 4,552 breast, 332 esophageal, 397 gastric, 878 pancreatic, 716 uterine cancers) were reported. Neither any aspirin nor aspirin use ≥3 times/week was associated with incidence of any of the investigated cancer types. However, multivariable regression analyses demonstrated that aspirin use ≥3 times/week was associated with increased bladder (HR, 0.67; 95% CI, 0.51-0.88) and breast (HR, 0.75; 95% CI, 0.59-0.96), but not esophageal, gastric, pancreatic, or uterine, cancer-specific survival. A similar association with bladder (HR, 0.75; 95% CI, 0.58, 0.98) and breast (HR, 0.79; 95% CI, 0.63, 0.99) cancer survival was observed with any aspirin use. In conclusion, any aspirin use and aspirin use ≥3 times/week was associated with improved bladder and breast cancer survival. The results of the current study provide suggestive observational evidence of the potential of aspirin use to improve bladder and breast cancer survival, however additional, follow-up studies are warranted. Citation Format: Holli A. Loomans-Kropp, Paul Pinsky, Asad Umar. Evaluation of aspirin use with cancer incidence and survival among older adults in the prostate, lung, colorectal, and ovarian cancer screening trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2570.
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