Abstract
Background and PurposeGrowing evidence has emerged and controversial results reported on possible relationship between aspirin use and lung cancer risk. We, therefore, conducted this updated and comprehensive meta-analysis to evaluate this issue, with focus on dose-risk and duration-risk relationships.MethodsWe searched electronic databases including PUBMED, EMBASE and Cochrane library to identify eligible studies. Relative risk (RR) and its 95% confidence interval (CI) were used for cohort studies, while odds ratio (OR) were employed for case-control studies. The random effects and fixed effects models were used for analyses.Results18 studies were identified including 19835 lung cancer cases, which were eligible for inclusion in the present meta-analysis. Pooled data from case-control studies showed a significant inverse association between regular aspirin use and lung cancer risk. But for cohort studies, insignificant association was detected with little evidence of heterogeneity (RR: 1.05, 95%CI: 0.95 – 1.16; I2: 10.3%, p value: 0.351). In case-control studies, standard aspirin use (>325mg) was related to lower lung cancer incidence, compared with low-dose aspirin use (75–100mg). A similar trend was observed in cohort studies. Besides, when analysis was restricted to long time regular aspirin use (>5 years), insignificant results were reported in both cohort and case-control studies. Finally, regular aspirin use might result in higher reduction of non-small cell lung cancer incidence among men.ConclusionsOur findings do not support the protective effect of regular aspirin use on lung cancer risk. Long time aspirin use, sex, dose and type of lung cancer might alter the effect of aspirin use on lung cancer risk. More well-designed studies are needed to further clarify these associations.
Highlights
Lung cancer is the most commonly diagnosed cancer with 1.61 million new cases in 2008, representing 12.7% of all cancer cases[1]
For cohort studies, insignificant association was detected with little evidence of heterogeneity (RR: 1.05, 95%confidence interval (CI): 0.95 – 1.16; I2: 10.3%, p value: 0.351)
Regular aspirin use might result in higher reduction of non-small cell lung cancer incidence among men
Summary
Lung cancer is the most commonly diagnosed cancer with 1.61 million new cases in 2008, representing 12.7% of all cancer cases[1]. As for mortality, Brasky et al [13] summarized the relevant data in Vitamins and Lifestyle Cohort and found that relative to non-use, neither high (!4 days/week and !4years) pre-diagnostic use of regular standard nor low-dose aspirin did not reduce lung cancer death (HR 0.99, 95% CI: 0.74 to 1.33 and HR: 0.89, 95% CI: 0.67 to 1.17, respectively) Another population-based cohort study performed by Jonsson et al [14] indicated that low-dose aspirin use was associated with lower tumor extent in lung cancer (p
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