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Summaries for Patients |1 September 2015

Associations Between the Use of Low-Dose Aspirin or Nonsteroidal Anti-inflammatory Drugs and Colorectal Cancer Risk Free

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information

  • The full report is titled “Low-Dose Aspirin or Nonsteroidal Anti-inflammatory Drug Use and Colorectal Cancer Risk. A Population-Based, Case–Control Study.” It is in the 1 September 2015 issue of Annals of Internal Medicine (volume 163, pages 347-355). The authors are S. Friis, A.H. Riis, R. Erichsen, J.A. Baron, and H.T. Sørensen.

    This article was published online first at www.annals.org on 25 August 2015.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
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What is the problem and what is known about it so far?

Some studies suggest that both aspirin and nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce a person's risk for colorectal cancer. Effects of these drugs on colorectal cancer risk may be delayed and only occur after long-term continuous use. Effects may also depend on dose and whether drugs are given every other day, once daily, or multiple times daily.

Why did the researchers do this particular study?

To examine associations between the use of low-dose aspirin and nonaspirin NSAIDs and risk for colorectal cancer.

Who was studied?

10,280 adults with an initial diagnosis of colorectal cancer and 102,800 adult control participants without colorectal cancer.

How was the study done?

Case patients and control participants were matched for age, sex, and area of residence. All participants lived in northern Denmark between 1994 and 2011. Researchers obtained data on drug use, comorbid conditions, and history of colonoscopy from prescription and patient registries. Low-dose aspirin (75 to 150 mg) and nonaspirin NSAID exposure were defined according to type, estimated dose, duration, and consistency of use. Researchers used logistic regression and adjusted for several characteristics to examine associations between patterns of drug use and risk for colorectal cancer.

What did the researchers find?

Continuous use of low-dose aspirin for 5 or more years was associated with reduced risk for colorectal cancer, but overall long-term use that was possibly discontinuous was not. Long-term, high-intensity use (average of ≥0.3 daily doses) of nonaspirin NSAIDs was also associated with reduced risk for colorectal cancer. Nonaspirin NSAIDs with the highest cyclooxygenase-2 selectivity were associated with the largest risk reductions.

What were the limitations of the study?

No data on over-the-counter purchases of aspirin and low-dose ibuprofen were available. Although the researchers did analyses that adjusted for multiple factors, they could not rule out the possibility of important confounding by colorectal cancer risk factors and could not definitively establish causality. Harms, such as bleeding risks, were not examined.

What are the implications of the study?

Continuous use of low-dose aspirin for 5 years or longer may be associated with decreased colorectal cancer risk.

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Associations Between the Use of Low-Dose Aspirin or Nonsteroidal Anti-inflammatory Drugs and Colorectal Cancer Risk. Ann Intern Med. 2015;163:I–44. doi: https://doi.org/10.7326/P15-9028

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Published: Ann Intern Med. 2015;163(5):I-44.

DOI: 10.7326/P15-9028

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