Aspirin and other non-steroidal anti-inflammatory drug prescriptions and survival after the diagnosis of head and neck and oesophageal cancer

Tatiana MacFarlane, Peter Murchie, Margaret C Watson

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Abstract

Background: Aspirin and other NSAIDs are widely used as analgesics and the former is a preventative agent for vascular events. It is unclear whether their longtermuse affects cancer risk. Data on the chemopreventative role of these drugs onthe mortality in patients with upper aerodigestive tract cancer (UADT) are insufficient. The aim of this study was to investigate the effect of aspirin and other NSAIDs on survival in UADT cancer patients.

Methods: An observational cohort study of patients with UADT cancer was undertaken using Primary Care Clinical Informatics Unit (PCCIU) database of electronic medical records in Scotland. Information was available on all prescriptions of aspirin and other NSAIDs before and after diagnosis. The main outcome measure was all-cause mortality. Cox regression was used for statistical data analysis.

Results: There were 2,392 patients diagnosed with UADT cancer between 1996 and 2010. Mean age of patients was 66 years (SD 12) and most were male (63%). Median survival in head and neck (HNC) patients was 94 months, while median survival in oesophageal cancer patients was 10 months. For HNC improved survival was observed with aspirin prescription (ever vs never Hazard Ratio (HR) 0.56 95% Confidence Interval (CI) 0.44, 0.71), there was no association with Cyclooxygenase 2 Inhibitors (COX-2) prescriptions. Improved survival was observed with other NSAIDs prescription (ever vs never HR 0.74 95% CI 0.60, 0.90). For oesophageal cancer patients, improved survival was observed with aspirin prescriptions (ever vs never HR 0.54 95% CI 0.45, 0.64), COX-2 prescriptions (HR 0.78 95% CI 0.62, 0.98) and other NSAIDs (HR 0.67 95% CI 0.56, 0.80).

Conclusions: Aspirin and other NSAIDs prescriptions after diagnosis are associated with a reduced all-cause mortality in UADT cancer patients.
Original languageEnglish
Pages (from-to)1015-1022
Number of pages8
JournalCancer Epidemiology
Volume39
Issue number6
Early online date18 Nov 2015
DOIs
Publication statusPublished - Dec 2015

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Drug Prescriptions
Esophageal Neoplasms
Head and Neck Neoplasms
Aspirin
Anti-Inflammatory Agents
Non-Steroidal Anti-Inflammatory Agents
Prescriptions
Survival
Neoplasms
Confidence Intervals
Cyclooxygenase 2 Inhibitors
Mortality
Neck
Head
Medical Informatics
Statistical Data Interpretation
Electronic Health Records
Scotland
Observational Studies
Blood Vessels

Keywords

  • aspirin
  • non-steroidal anti-inflammatory agents
  • head and neck cancer
  • oesophageal cancer
  • survival
  • prognosis
  • computerized medical records

Cite this

@article{45d84c57255f4bffa03ed2e78241c383,
title = "Aspirin and other non-steroidal anti-inflammatory drug prescriptions and survival after the diagnosis of head and neck and oesophageal cancer",
abstract = "Background: Aspirin and other NSAIDs are widely used as analgesics and the former is a preventative agent for vascular events. It is unclear whether their longtermuse affects cancer risk. Data on the chemopreventative role of these drugs onthe mortality in patients with upper aerodigestive tract cancer (UADT) are insufficient. The aim of this study was to investigate the effect of aspirin and other NSAIDs on survival in UADT cancer patients.Methods: An observational cohort study of patients with UADT cancer was undertaken using Primary Care Clinical Informatics Unit (PCCIU) database of electronic medical records in Scotland. Information was available on all prescriptions of aspirin and other NSAIDs before and after diagnosis. The main outcome measure was all-cause mortality. Cox regression was used for statistical data analysis. Results: There were 2,392 patients diagnosed with UADT cancer between 1996 and 2010. Mean age of patients was 66 years (SD 12) and most were male (63{\%}). Median survival in head and neck (HNC) patients was 94 months, while median survival in oesophageal cancer patients was 10 months. For HNC improved survival was observed with aspirin prescription (ever vs never Hazard Ratio (HR) 0.56 95{\%} Confidence Interval (CI) 0.44, 0.71), there was no association with Cyclooxygenase 2 Inhibitors (COX-2) prescriptions. Improved survival was observed with other NSAIDs prescription (ever vs never HR 0.74 95{\%} CI 0.60, 0.90). For oesophageal cancer patients, improved survival was observed with aspirin prescriptions (ever vs never HR 0.54 95{\%} CI 0.45, 0.64), COX-2 prescriptions (HR 0.78 95{\%} CI 0.62, 0.98) and other NSAIDs (HR 0.67 95{\%} CI 0.56, 0.80). Conclusions: Aspirin and other NSAIDs prescriptions after diagnosis are associated with a reduced all-cause mortality in UADT cancer patients.",
keywords = "aspirin, non-steroidal anti-inflammatory agents, head and neck cancer, oesophageal cancer, survival , prognosis, computerized medical records",
author = "Tatiana MacFarlane and Peter Murchie and Watson, {Margaret C}",
note = "Acknowledgements We thank the PCCIUR staff and Data Management Team for preparing the data for this study: James Bellarby, Katie Wilde and Karen Lefevre. We are grateful to the anonymous referees for very helpful comments and suggestions.",
year = "2015",
month = "12",
doi = "10.1016/j.canep.2015.10.030",
language = "English",
volume = "39",
pages = "1015--1022",
journal = "Cancer Epidemiology",
issn = "1877-7821",
publisher = "Elsevier BV",
number = "6",

}

TY - JOUR

T1 - Aspirin and other non-steroidal anti-inflammatory drug prescriptions and survival after the diagnosis of head and neck and oesophageal cancer

AU - MacFarlane, Tatiana

AU - Murchie, Peter

AU - Watson, Margaret C

N1 - Acknowledgements We thank the PCCIUR staff and Data Management Team for preparing the data for this study: James Bellarby, Katie Wilde and Karen Lefevre. We are grateful to the anonymous referees for very helpful comments and suggestions.

PY - 2015/12

Y1 - 2015/12

N2 - Background: Aspirin and other NSAIDs are widely used as analgesics and the former is a preventative agent for vascular events. It is unclear whether their longtermuse affects cancer risk. Data on the chemopreventative role of these drugs onthe mortality in patients with upper aerodigestive tract cancer (UADT) are insufficient. The aim of this study was to investigate the effect of aspirin and other NSAIDs on survival in UADT cancer patients.Methods: An observational cohort study of patients with UADT cancer was undertaken using Primary Care Clinical Informatics Unit (PCCIU) database of electronic medical records in Scotland. Information was available on all prescriptions of aspirin and other NSAIDs before and after diagnosis. The main outcome measure was all-cause mortality. Cox regression was used for statistical data analysis. Results: There were 2,392 patients diagnosed with UADT cancer between 1996 and 2010. Mean age of patients was 66 years (SD 12) and most were male (63%). Median survival in head and neck (HNC) patients was 94 months, while median survival in oesophageal cancer patients was 10 months. For HNC improved survival was observed with aspirin prescription (ever vs never Hazard Ratio (HR) 0.56 95% Confidence Interval (CI) 0.44, 0.71), there was no association with Cyclooxygenase 2 Inhibitors (COX-2) prescriptions. Improved survival was observed with other NSAIDs prescription (ever vs never HR 0.74 95% CI 0.60, 0.90). For oesophageal cancer patients, improved survival was observed with aspirin prescriptions (ever vs never HR 0.54 95% CI 0.45, 0.64), COX-2 prescriptions (HR 0.78 95% CI 0.62, 0.98) and other NSAIDs (HR 0.67 95% CI 0.56, 0.80). Conclusions: Aspirin and other NSAIDs prescriptions after diagnosis are associated with a reduced all-cause mortality in UADT cancer patients.

AB - Background: Aspirin and other NSAIDs are widely used as analgesics and the former is a preventative agent for vascular events. It is unclear whether their longtermuse affects cancer risk. Data on the chemopreventative role of these drugs onthe mortality in patients with upper aerodigestive tract cancer (UADT) are insufficient. The aim of this study was to investigate the effect of aspirin and other NSAIDs on survival in UADT cancer patients.Methods: An observational cohort study of patients with UADT cancer was undertaken using Primary Care Clinical Informatics Unit (PCCIU) database of electronic medical records in Scotland. Information was available on all prescriptions of aspirin and other NSAIDs before and after diagnosis. The main outcome measure was all-cause mortality. Cox regression was used for statistical data analysis. Results: There were 2,392 patients diagnosed with UADT cancer between 1996 and 2010. Mean age of patients was 66 years (SD 12) and most were male (63%). Median survival in head and neck (HNC) patients was 94 months, while median survival in oesophageal cancer patients was 10 months. For HNC improved survival was observed with aspirin prescription (ever vs never Hazard Ratio (HR) 0.56 95% Confidence Interval (CI) 0.44, 0.71), there was no association with Cyclooxygenase 2 Inhibitors (COX-2) prescriptions. Improved survival was observed with other NSAIDs prescription (ever vs never HR 0.74 95% CI 0.60, 0.90). For oesophageal cancer patients, improved survival was observed with aspirin prescriptions (ever vs never HR 0.54 95% CI 0.45, 0.64), COX-2 prescriptions (HR 0.78 95% CI 0.62, 0.98) and other NSAIDs (HR 0.67 95% CI 0.56, 0.80). Conclusions: Aspirin and other NSAIDs prescriptions after diagnosis are associated with a reduced all-cause mortality in UADT cancer patients.

KW - aspirin

KW - non-steroidal anti-inflammatory agents

KW - head and neck cancer

KW - oesophageal cancer

KW - survival

KW - prognosis

KW - computerized medical records

U2 - 10.1016/j.canep.2015.10.030

DO - 10.1016/j.canep.2015.10.030

M3 - Article

VL - 39

SP - 1015

EP - 1022

JO - Cancer Epidemiology

JF - Cancer Epidemiology

SN - 1877-7821

IS - 6

ER -