Abstract
BackgroundAspirin has been found to lower the occurrence rates of some cancers through the inhibition of the cyclooxygenase enzyme. For example, there is a well-known association between aspirin use and the occurrence of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) carriers. However, the association, if any, between aspirin use and HCC in hepatitis C virus (HCV) carriers is unknown. Therefore, this study compared the occurrence rates of HCC in HCV carriers treated with or without aspirin.MethodsThe participants in this retrospective cohort study consisted of people newly diagnosed with HCV in Taiwan from 2000 to 2012. Those who were treated with aspirin were defined as the control group, whereas those not treated with aspirin were defined as the comparison cohort. We used a 1:1 propensity score matching by age, sex, comorbidities, drugs, diagnosis year, and index year with covariate assessment.ResultsOur study sample consisted of 2980 aspirin-treated HCV carriers and 7771 non-aspirin-treated HCV carriers. After propensity score matching, each cohort consisted of 1911 HCV carriers. The adjusted hazard ratio (aHR) of HCC incidence in the aspirin users (aHR = 0.56, 95% CI = 0.43–0.72, p < 0.001) was significantly lower than that in the non-aspirin users. A Kaplan-Meier analysis showed that among the HCV carriers, the aspirin users had a lower cumulative incidence rate of HCC over the first 10 years of aspirin treatment (p < 0.0001).ConclusionsThe HCC incidence rate was lower in the aspirin-using HCV carriers than in the non- aspirin-using HCV carriers, indicating that the effects of aspirin might occur through inhibition of the cyclooxygenase enzyme pathway. Moreover, protection from HCC was provided by less than a year of aspirin treatment, while treatment with aspirin for 1 to 2 years exhibited the greatest protective effect. We therefore encourage aspirin treatment to prevent HCC in HCV carriers.
Highlights
Aspirin has been found to lower the occurrence rates of some cancers through the inhibition of the cyclooxygenase enzyme
The final study population consisted of 1911 hepatitis C virus (HCV) carriers treated with aspirin and 1911 HCV carriers not treated with aspirin
The proportions of patients in the aspirintreated group who used antihypertensive agents, coumadin and heparin, antithrombotic agents, and non-steroidal anti-inflammatory drugs (NSAIDs) were significantly greater than the proportions of patients in the non-aspirin-treated group who did so, there was no significant difference between the two groups in terms of the proportions who used hypoglycemic agents
Summary
Aspirin has been found to lower the occurrence rates of some cancers through the inhibition of the cyclooxygenase enzyme. There is a well-known association between aspirin use and the occurrence of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) carriers. The association, if any, between aspirin use and HCC in hepatitis C virus (HCV) carriers is unknown. This study compared the occurrence rates of HCC in HCV carriers treated with or without aspirin. Hepatitis B virus (HBV) infections, hepatitis C virus (HCV) infections, and alcoholic liver cirrhosis are the main risk factors for HCC [3,4,5]. Aspirin has been widely used as an analgesic and antiinflammatory drug. It plays an important role in preventing cerebrovascular and cardiovascular thrombosis and even lowering the associated mortality, especially in diabetes mellitus patients [7,8,9,10]. Aspirin may prevent the occurrence of some cancers, such as colorectal cancer [11,12,13,14], lung cancer [15], prostate cancer [16], and head and neck cancer [17], as well as (2020) 20:6
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