title: Aspirin and other non-steroidal anti-inflammatory drug prescriptions and survival after the diagnosis of head and neck and oesophageal cancer.
abstract: BACKGROUND
  Aspirin and other NSAIDs are widely used as analgesics and the former is a preventative agent for vascular events. It is unclear whether their long-term use affects cancer risk. Data on the chemopreventative role of these drugs on the mortality in patients with upper aerodigestive tract cancer (UADT) are insufficient. The aim of this study was to investigate the effect of aspirin and other NSAIDs on survival in UADT cancer patients.
  
  
  METHODS
  An observational cohort study of patients with UADT cancer was undertaken using Primary Care Clinical Informatics Unit (PCCIU) database of electronic medical records in Scotland. Information was available on all prescriptions of aspirin and other NSAIDs before and after diagnosis. The main outcome measure was all-cause mortality. Cox regression was used for statistical data analysis.
  
  
  RESULTS
  There were 2392 patients diagnosed with UADT cancer between 1996 and 2010. Mean age of patients was 66 years (SD 12) and most were male (63%). Median survival in head and neck (HNC) patients was 94 months, while median survival in oesophageal cancer patients was 10 months. For HNC improved survival was observed with aspirin prescription (ever vs never hazard ratio (HR) 0.56 95% Confidence Interval (CI) 0.44, 0.71), there was no association with Cyclooxygenase 2 Inhibitors (COX-2) prescriptions. Improved survival was observed with other NSAIDs prescription (ever vs never HR 0.74 95% CI 0.60, 0.90). For oesophageal cancer patients, improved survival was observed with aspirin prescriptions (ever vs never HR 0.54 95% CI 0.45, 0.64), COX-2 prescriptions (HR 0.78 95% CI 0.62, 0.98) and other NSAIDs (HR 0.67 95% CI 0.56, 0.80).
  
  
  CONCLUSIONS
  Aspirin and other NSAIDs prescriptions after diagnosis are associated with a reduced all-cause mortality in UADT cancer patients.
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Dental School and Hospital, Cornhill Road, Foresterhill, Aberdeen AB25 2ZR, United Kingdom. Electronic address: Tatiana.Macfarlane@abdn.ac.uk.
authors.forename: Tatiana V
authors.initials: TV
authors.lastname: Macfarlane
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Dental School and Hospital, Cornhill Road, Foresterhill, Aberdeen AB25 2ZR, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Murchie
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Dental School and Hospital, Cornhill Road, Foresterhill, Aberdeen AB25 2ZR, United Kingdom.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Watson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012606:Scotland; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Aspirin; Computerized medical records; Head and neck cancer; Non-steroidal anti-inflammatory agents; Oesophageal cancer; Prognosis; Survival