Charlotte Skriver, MSc; Christian Dehlendorff, MSc, PhD; Michael Borre, MD, PhD, DMSc; Klaus Brasso, MD, PhD; Signe Benzon Larsen, MSc, PhD; Susanne Oksbjerg Dalton, MD, PhD; Mette Nørgaard, MD, PhD; Anton Pottegård, MSc, PhD; Jesper Hallas, MD, DMSc; Henrik Toft Sørensen, MD, PhD, DMSc; Søren Friis, MD
Grant Support: By grant R79-A5286 from the Danish Cancer Society.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3085.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Reproducible Research Statement: Study protocol: Not available. Statistical code: Available to interested readers by contacting Dr. Dehlendorff (e-mail, email@example.com). Data set: Not available.
Corresponding Author: Charlotte Skriver, MSc, Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark; e-mail, firstname.lastname@example.org.
Current Author Addresses: Ms. Skriver and Drs. Dehlendorff, Dalton, and Friis: Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark.
Dr. Borre: Department of Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark.
Drs. Brasso and Larsen: Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Ole Maaløes Vej 24, DK-2200 Copenhagen N, Denmark.
Drs. Nørgaard and Sørensen: Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43–45, DK-8200 Aarhus N, Denmark.
Drs. Pottegård and Hallas: Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 19, DK-5000 Odense C, Denmark.
Author Contributions: Conception and design: C. Skriver, C. Dehlendorff, M. Borre, K. Brasso, S.O. Dalton, A. Pottegård, J. Hallas, H.T. Sørensen, S. Friis.
Analysis and interpretation of the data: C. Skriver, C. Dehlendorff, M. Borre, K. Brasso, S.B. Larsen, S.O. Dalton, M. Nørgaard, A. Pottegård, J. Hallas, S. Friis.
Drafting of the article: C. Skriver, K. Brasso, S.B. Larsen, S.O. Dalton, S. Friis.
Critical revision for important intellectual content: C. Dehlendorff, M. Borre, S.B. Larsen, S.O. Dalton, M. Nørgaard, A. Pottegård, J. Hallas, H.T. Sørensen, S. Friis.
Final approval of the article: C. Skriver, C. Dehlendorff, M. Borre, K. Brasso, S.B. Larsen, S.O. Dalton, M. Nørgaard, A. Pottegård, J. Hallas, H.T. Sørensen, S. Friis.
Statistical expertise: C. Dehlendorff, A. Pottegård.
Obtaining of funding: C. Skriver, S. Friis.
Collection and assembly of data: C. Dehlendorff, C. Skriver, S. Friis.
Recent studies suggest that aspirin use may improve survival in patients with prostate cancer.
To assess the association between postdiagnosis use of low-dose aspirin and prostate cancer mortality.
Nationwide cohort study.
Men with incident prostate adenocarcinoma between 2000 and 2011.
Nationwide registry data on tumor characteristics, drug use, primary prostate cancer therapy, comorbidity, and socioeconomic parameters. Postdiagnosis use of low-dose aspirin (75 to 150 mg) was defined as 2 or more prescriptions filled within 1 year after prostate cancer diagnosis. Follow-up started 1 year after prostate cancer diagnosis. In secondary analyses, low-dose aspirin use was assessed within exposure periods of 5 or 7.5 years after prostate cancer diagnosis.
Of 29 136 patients (median age, 70 years), 7633 died of prostate cancer and 5575 died of other causes during a median follow-up of 4.9 years (interquartile range, 3.1 to 7.2 years), through 2015. Postdiagnosis low-dose aspirin use was associated with adjusted hazard ratios (HRs) of 0.95 (95% CI, 0.89 to 1.01) for prostate cancer–specific mortality and 1.12 (CI, 1.05 to 1.20) for other-cause mortality. The secondary analyses showed that prostate cancer mortality was slightly reduced with low-dose aspirin use after the 5-year (HR, 0.91 [CI, 0.83 to 1.01]) and 7.5-year (HR, 0.84 [CI, 0.72 to 0.97]) postdiagnosis exposure periods, notably among patients filling prescriptions for a large quantity of low-dose aspirin tablets during the 7.5-year period.
Data on over-the-counter aspirin use were unavailable. Some residual confounding was possible as a result of incomplete data on some prognostic factors.
The study did not support an overall effect of postdiagnosis low-dose aspirin use on prostate cancer mortality. However, results for extended exposure periods suggest that low-dose aspirin use might be inversely associated with prostate cancer mortality after 5 years from cancer diagnosis
Danish Cancer Society.
Skriver C, Dehlendorff C, Borre M, et al. Use of Low-Dose Aspirin and Mortality After Prostate Cancer Diagnosis: A Nationwide Cohort Study. Ann Intern Med. 2019;170:443–452. [Epub ahead of print 5 March 2019]. doi: 10.7326/M17-3085
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Published: Ann Intern Med. 2019;170(7):443-452.
Published at www.annals.org on 5 March 2019
Hematology/Oncology, Prostate Cancer.
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Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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