title: Aspirin As Secondary Prevention in Patients With Colorectal Cancer: An Unselected Population-Based Study.
abstract: Regular use of aspirin (acetylsalicylic acid) is associated with reduced incidence and mortality of colorectal cancer (CRC). However, aspirin as primary prevention is debated because of the risk of hemorrhagic adverse effects. Aspirin as secondary prevention may be more justified from a risk-benefit perspective. We have examined the association between aspirin use after the diagnosis of CRC with CRC-specific survival (CSS) and overall survival (OS).
  
  
  
  An observational, population-based, retrospective cohort study was conducted by linking patients diagnosed with CRC from 2004 through 2011 (Cancer Registry of Norway) with data on their aspirin use (The Norwegian Prescription Database). These registries cover more than 99% of the Norwegian population and include all patients in an unselected and consecutive manner. Exposure to aspirin was defined as receipt of aspirin prescriptions for more than 6 months after the diagnosis of CRC. Multivariable Cox-proportional hazard analyses were used to model survival. The main outcome measures of the study were CSS and OS.
  
  
  
  A total of 23,162 patients diagnosed with CRC were included, 6,102 of whom were exposed to aspirin after the diagnosis of CRC (26.3%). The median follow-up time was 3.0 years. A total of 2,071 deaths (32.9%, all causes) occurred among aspirin-exposed patients, of which 1,158 (19.0%) were CRC specific. Among unexposed patients (n = 17,060), there were 7,218 deaths (42.3%), of which 5,375 (31.5%) were CRC specific. In multivariable analysis, aspirin exposure after the diagnosis of CRC was independently associated with improved CSS (hazard ratio [HR], 0.85; 95% CI, 0.79 to 0.92) and OS (HR, 0.95; 95% CI, 0.90 to 1.01).
  
  
  
  Aspirin use after the diagnosis of CRC is independently associated with improved CSS and OS.
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Simer J
authors.initials: SJ
authors.lastname: Bains
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Milada
authors.initials: M
authors.lastname: Mahic
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Tor Åge
authors.initials: TÅ
authors.lastname: Myklebust
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Milada Cvancarova
authors.initials: MC
authors.lastname: Småstuen
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Sheraz
authors.initials: S
authors.lastname: Yaqub
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Liv Marit
authors.initials: LM
authors.lastname: Dørum
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Bjørn Atle
authors.initials: BA
authors.lastname: Bjørnbeth
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Møller
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway.
authors.forename: Kristoffer Watten
authors.initials: KW
authors.lastname: Brudvik
authors.affiliation: Simer J. Bains, Kjetil Taskén, Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo; Milada Mahic, Norwegian Institute of Public Health; Tor Åge Myklebust, Liv Marit Dørum, Bjørn Møller, Cancer Registry of Norway; and Simer J. Bains, Milada Cvancarova Småstuen, Sheraz Yaqub, Bjørn Atle Bjørnbeth, Kristoffer Watten Brudvik, Kjetil Taskén, Oslo University Hospital, Oslo, Norway kjetil.tasken@ncmm.uio.no.
authors.forename: Kjetil
authors.initials: K
authors.lastname: Taskén
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D015982:Bias; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055502:Secondary Prevention
chemical_list: D001241:Aspirin