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Previous studies have shown that long-term use of aspirin reduces the risk of colorectal cancer (CRC), but it is not clear whether taking aspirin after diagnosis of CRC will also have survival benefits.
, there was no data on whether taking non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) had the same effect.
this forward-looking analysis included subjects in the Cancer Prevention Research-II nutrition queue who did not have cancer at baseline (1992-1993) and were diagnosed with CRC in follow-up prior to 2015.
self-reporting using questionnaires on aspirin and non-aspirin NSAID use is provided every 2 years.
2,686 subjects and 1,931 subjects without distant transfers had pre- and post-diagnosis data, respectively, 512 and 251 died of CRC during follow-up as of 2016.
the average age of 73.5 years when the subjects were diagnosed with CRC, and those who regularly used aspirin were more likely to have a history of cardiovascular disease (CVD) and/or diabetes, mostly taking clopidogrere intervention at the same time.
Taking aspirin for a long period of time (≥15 times/month) before diagnosis of CRC can significantly reduce CRC-specific mortality (multivariate adjusted risk ratio of HR 0.69).
Although subjects who started taking aspirin regularly after diagnosis had a lower risk of CRC-specific death than those who did not use aspirin before or after diagnosis, neither aspirin nor non-aspirin NSAID significantly reduced CRC specific mortality (average follow-up 9.4 years; HR 0.82) after diagnosis.
long-term use of aspirin was also associated with a lower risk of distant metastasis after colorectal cancer (multivariable adjusted HR 0.73).
the results suggest that long-term aspirin use in patients with non-metastatic colorectal cancer before diagnosis may be associated with a lower CRC-specific mortality rate after diagnosis, consistent with the possibility of inhibition of micro-transfer before diagnosis.
aspirin after being diagnosed with colorectal cancer does not significantly reduce the risk of death.