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Low-dose aspirin and survival in men with prostate cancer: a study using the UK Clinical Practice Research Datalink

Abstract

Purpose

Aspirin use is associated with reduced risk of, and death from, prostate cancer. Our aim was to determine whether low-dose aspirin use after a prostate cancer diagnosis was associated with reduced prostate cancer-specific mortality.

Methods

A cohort of newly diagnosed prostate cancer patients (1998–2006) was identified in the UK Clinical Practice Research Datalink (confirmed by cancer registry linkage). A nested case–control analysis was conducted using conditional logistic regression to compare aspirin usage in cases (prostate cancer deaths) with up to three controls (matched by age and year of diagnosis).

Results

Post-diagnostic low-dose aspirin use was identified in 52 % of 1,184 prostate cancer-specific deaths and 39 % of 3,531 matched controls (unadjusted OR 1.51, 95 % CI 1.19, 1.90; p < 0.001). After adjustment for confounders including treatment and comorbidities, this association was attenuated (adjusted OR  1.02 95 % CI 0.78, 1.34; p = 0.86). Adjustment for estrogen therapy accounted for the majority of this attenuation. There was also no evidence of dose–response association after adjustments. Compared with no use, patients with 1–11 prescriptions and 12 or more prescriptions had adjusted ORs of 1.07 (95 % CI 0.78, 1.47; p = 0.66) and 0.97 (95 % CI 0.69, 1.37; p = 0.88), respectively. There was no evidence of a protective association between low-dose aspirin use in the year prior to diagnosis and prostate cancer-specific mortality (adjusted OR 1.04 95 % CI 0.89, 1.22; p = 0.60).

Conclusion

We found no evidence of an association between low-dose aspirin use before or after diagnosis and risk of prostate cancer-specific mortality, after potential confounders were accounted for, in UK prostate cancer patients.

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Acknowledgments

This study is based on part of the data from the General Practice Research Database obtained under license from the UK Medicines and Healthcare Regulatory Agency. This work was supported by a Cancer Research-UK Project Grant (C19630/A13265). CRC was supported by a Health and Social Care Research and Development, Public Health Agency, Northern Ireland, funded by UK National Institute for Health Research Career Development Fellowship. EMF is supported by a PhD studentship from the Irish Cancer Society (CRS10FLA). The funders had no role in the study design; collection, analysis, and interpretation of the data; writing of the report; or the decision to submit for publication.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Chris R. Cardwell.

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Cardwell, C.R., Flahavan, E.M., Hughes, C.M. et al. Low-dose aspirin and survival in men with prostate cancer: a study using the UK Clinical Practice Research Datalink. Cancer Causes Control 25, 33–43 (2014). https://doi.org/10.1007/s10552-013-0306-x

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  • DOI: https://doi.org/10.1007/s10552-013-0306-x

Keywords

  • Aspirin
  • Prostate cancer
  • Mortality