Yin Zhang1,2,3, Andrew T Chan4,5,6,7, Jeffrey A Meyerhardt2, Edward L Giovannucci1,3,8. 1. Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 2. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 3. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 4. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 5. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 6. Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA. 7. Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 8. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: Prior epidemiological and intervention studies have not been able to separate independent effects of dose, timing, and duration of aspirin use in colorectal cancer (CRC) chemoprevention. We examined aspirin-based CRC chemoprevention according to timing in the Nurses' Health Study and Health Professionals Follow-Up Study. METHODS: The exposures include cumulative average dose and total duration of aspirin use in more than 10 years before follow-up started (remote period) and in the immediate 10 years before follow-up started (recent period). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for exposures and CRC risk. RESULTS: Aspirin use of longer than 10 years before follow-up started (HR = 0.88, 95% CI = 0.83 to 0.94) per 5-year increment and the immediate 10 years before follow-up started (HR = 0.90, 95% CI = 0.84 to 0.96) were similarly important in CRC chemoprevention, though a 5-year lag was required for a clear benefit in the recent period. In the remote period, the association was not dose dependent; compared with less than 0.5 standard-dose (325 mg) tablets per week; hazard ratios were 0.78 (95% CI = 0.63 to 0.98), 0.81 (95% CI = 0.72 to 0.91), and 0.74 (95% CI = 0.64 to 0.86) for doses of 0.5 to less than 1.5, 1.5 to less than 5, and 5 and more tablets per week, respectively. However, there was dose dependency in the recent period (with respective HR = 0.91, 95% CI = 0.79 to 1.06; HR = 0.87, 95% CI = 0.77 to 0.98; and HR = 0.76, 95% CI = 0.64 to 0.91). CONCLUSIONS: A suggestive benefit necessitates at least 6-10 years and most clearly after approximately 10 years since initiation of aspirin. Remote use and use within the previous 10 years both contribute independently to decrease risk, though a lower dose may be required for a benefit with longer term use.
BACKGROUND: Prior epidemiological and intervention studies have not been able to separate independent effects of dose, timing, and duration of aspirin use in colorectal cancer (CRC) chemoprevention. We examined aspirin-based CRC chemoprevention according to timing in the Nurses' Health Study and Health Professionals Follow-Up Study. METHODS: The exposures include cumulative average dose and total duration of aspirin use in more than 10 years before follow-up started (remote period) and in the immediate 10 years before follow-up started (recent period). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for exposures and CRC risk. RESULTS: Aspirin use of longer than 10 years before follow-up started (HR = 0.88, 95% CI = 0.83 to 0.94) per 5-year increment and the immediate 10 years before follow-up started (HR = 0.90, 95% CI = 0.84 to 0.96) were similarly important in CRC chemoprevention, though a 5-year lag was required for a clear benefit in the recent period. In the remote period, the association was not dose dependent; compared with less than 0.5 standard-dose (325 mg) tablets per week; hazard ratios were 0.78 (95% CI = 0.63 to 0.98), 0.81 (95% CI = 0.72 to 0.91), and 0.74 (95% CI = 0.64 to 0.86) for doses of 0.5 to less than 1.5, 1.5 to less than 5, and 5 and more tablets per week, respectively. However, there was dose dependency in the recent period (with respective HR = 0.91, 95% CI = 0.79 to 1.06; HR = 0.87, 95% CI = 0.77 to 0.98; and HR = 0.76, 95% CI = 0.64 to 0.91). CONCLUSIONS: A suggestive benefit necessitates at least 6-10 years and most clearly after approximately 10 years since initiation of aspirin. Remote use and use within the previous 10 years both contribute independently to decrease risk, though a lower dose may be required for a benefit with longer term use.
Authors: Peter M Rothwell; Michelle Wilson; Carl-Eric Elwin; Bo Norrving; Ale Algra; Charles P Warlow; Tom W Meade Journal: Lancet Date: 2010-10-21 Impact factor: 79.321
Authors: Stephen P Fink; Mai Yamauchi; Reiko Nishihara; Seungyoun Jung; Aya Kuchiba; Kana Wu; Eunyoung Cho; Edward Giovannucci; Charles S Fuchs; Shuji Ogino; Sanford D Markowitz; Andrew T Chan Journal: Sci Transl Med Date: 2014-04-23 Impact factor: 17.956
Authors: Yin Cao; Reiko Nishihara; Zhi Rong Qian; Mingyang Song; Kosuke Mima; Kentaro Inamura; Jonathan A Nowak; David A Drew; Paul Lochhead; Katsuhiko Nosho; Teppei Morikawa; Xuehong Zhang; Kana Wu; Molin Wang; Wendy S Garrett; Edward L Giovannucci; Charles S Fuchs; Andrew T Chan; Shuji Ogino Journal: Gastroenterology Date: 2016-07-27 Impact factor: 22.682
Authors: Jessica Chubak; Evelyn P Whitlock; Selvi B Williams; Aruna Kamineni; Brittany U Burda; Diana S M Buist; Melissa L Anderson Journal: Ann Intern Med Date: 2016-04-12 Impact factor: 25.391
Authors: Peter M Rothwell; Nancy R Cook; J Michael Gaziano; Jacqueline F Price; Jill F F Belch; Maria Carla Roncaglioni; Takeshi Morimoto; Ziyah Mehta Journal: Lancet Date: 2018-07-17 Impact factor: 79.321
Authors: Mohammad Movahedi; D Timothy Bishop; Finlay Macrae; Jukka-Pekka Mecklin; Gabriela Moeslein; Sylviane Olschwang; Diana Eccles; D Gareth Evans; Eamonn R Maher; Lucio Bertario; Marie-Luise Bisgaard; Malcolm G Dunlop; Judy W C Ho; Shirley V Hodgson; Annika Lindblom; Jan Lubinski; Patrick J Morrison; Victoria Murday; Raj S Ramesar; Lucy Side; Rodney J Scott; Huw J W Thomas; Hans F Vasen; John Burn; John C Mathers Journal: J Clin Oncol Date: 2015-08-17 Impact factor: 44.544
Authors: Yin Zhang; Mingyang Song; Andrew T Chan; Jeffrey A Meyerhardt; Walter C Willett; Edward L Giovannucci Journal: Br J Cancer Date: 2022-09-22 Impact factor: 9.075
Authors: Andrew Bakshi; Yin Cao; Paul Lacaze; Andrew T Chan; Suzanne G Orchard; Prudence R Carr; Amit D Joshi; Alisa K Manning; Daniel D Buchanan; Asad Umar; Ingrid M Winship; Peter Gibbs; John R Zalcberg; Finlay Macrae; John J McNeil Journal: Cancer Prev Res (Phila) Date: 2022-07-05
Authors: Yin Zhang; Kana Wu; Andrew T Chan; Jeffrey A Meyerhardt; Edward L Giovannucci Journal: Am J Gastroenterol Date: 2022-01-01 Impact factor: 12.045