Chemopreventive effect of long-term use of low-dose aspirin on lung cancer risk: A nationwide study considering competing risk

Abstract

Background: Long term use of low dose aspirin has been considered to reduce the risks of cancers. We aimed to investigate the association between regular use of low-dose aspirin and lung cancer risk in a large population based cohort study. Methods: We conducted a retrospective cohort study and analyzed claim data from Korea national health insurance service. A total of 12,570,961 individuals who aged 40–84 years old at 2010, only those who underwent health examinations between January 1, 2009 and December 31 were finally enrolled and were followed from a baseline (January 1, 2011) until maximum end of follow up (December 31, 2015). In statistical analysis, we implemented the competing risk analysis (Fine and Gray model) for identifying the association between duration of long-term use of low-dose aspirin and lung cancer risk with considering competing event as death. Results: In all study population, the long term use of low-dose aspirin (100mg) was significantly associated with reduced risk of lung cancer (9 years versus non-user: HR, 0.92; 95% CI, 0.86-0.98). After stratification by sex, age, BMI ( body mass index) and smoking status, low-dose aspirin use was significantly associated with a decreased risk of lung cancer in men (HR, 0.92), ≥65 years old person (HR, 0.89), non-obese person (HR, 0.86), and non-smoker (HR, 0.89). Conclusions: We found that regular use of low-dose aspirin more than nine years was associated with a decreased risk of lung cancer, with the strongest evidence for a chemoprotective effect in men, non-obese people, non-smoker and elderly people.