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. 2023 Feb 24;20(5):4104.
doi: 10.3390/ijerph20054104.

Acetylsalicylic Acid Effect in Colorectal Cancer Taking into Account the Role of Tobacco, Alcohol and Excess Weight

Didac Florensa  1   2 , Jordi Mateo  1 , Francesc Solsona  1 , Leonardo Galván  3 , Miquel Mesas  4 , Ramon Piñol  5 , Leonardo Espinosa-Leal  6 , Pere Godoy  2   7   8
Affiliations

Acetylsalicylic Acid Effect in Colorectal Cancer Taking into Account the Role of Tobacco, Alcohol and Excess Weight

Didac Florensa et al. Int J Environ Res Public Health. .

Abstract

Excess weight, smoking and risky drinking are preventable risk factors for colorectal cancer (CRC). However, several studies have reported a protective association between aspirin and the risk of CRC. This article looks deeper into the relationships between risk factors and aspirin use with the risk of developing CRC. We performed a retrospective cohort study of CRC risk factors and aspirin use in persons aged >50 years in Lleida province. The participants were inhabitants with some medication prescribed between 2007 and 2016 that were linked to the Population-Based Cancer Registry to detect CRC diagnosed between 2012 and 2016. Risk factors and aspirin use were studied using the adjusted HR (aHR) with 95% confidence intervals (CI) using a Cox proportional hazard model. We included 154,715 inhabitants of Lleida (Spain) aged >50 years. Of patients with CRC, 62% were male (HR = 1.8; 95% CI: 1.6-2.2), 39.5% were overweight (HR = 2.8; 95% CI: 2.3-3.4) and 47.3% were obese (HR = 3.0; 95% CI: 2.6-3.6). Cox regression showed an association between aspirin and CRC (aHR = 0.7; 95% CI: 0.6-0.8), confirming a protective effect against CRC and an association between the risk of CRC and excess weight (aHR = 1.4; 95% CI: 1.2-1.7), smoking (aHR = 1.4; 95% CI: 1.3-1.7) and risky drinking (aHR = 1.6; 95% CI: 1.2-2.0). Our results show that aspirin use decreased the risk of CRC and corroborate the relationship between overweight, smoking and risky drinking and the risk of CRC.

Keywords: aspirin use; colorectal cancer; excess weight; risky drinking; smoking.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of subjects included for the analysis.
Figure 2
Figure 2
(a) Total CRC cases by age groups and sex for 5 years. (b) Mean observed CRC incidence by age groups and sex during one year.
Figure 3
Figure 3
Hazard ratios by Cox regression adjusted for gender, age, aspirin use, BMI, risky drinking and tobacco smoking.
Figure 4
Figure 4
Hazard ratios by Cox regression stratified by males and females. Adjusted for age, aspirin use, BMI, risky drinking and tobacco smoking.
See this image and copyright information in PMC

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