Cheung, KS;
Chan, EW;
Wong, AYS;
Chen, L;
Seto, K;
Wong, ICK;
Leung, WK;
(2018)
Aspirin and Risk of Gastric Cancer After Helicobacter pylori Eradication: A Territory-Wide Study.
Journal of the National Cancer Institute
, 110
(7)
pp. 743-749.
10.1093/jnci/djx267.
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Abstract
Background: Despite successful H. pylori (HP) eradication, some individuals remain at risk of developing gastric cancer (GC). Previous studies showed that aspirin was associated with a reduced GC risk. However, whether aspirin can reduce GC risk in HP-eradicated subjects remains unknown. We aimed to determine the chemopreventive effect of aspirin in HP-eradicated subjects. Methods: We identified subjects who had received a prescription of clarithromycin-based triple therapy for HP between 2003 and 2012 from a territory-wide healthcare database. The observation period started from commencement of HP therapy (index date), and the follow-up was censored at the end of the study (December 2015), death or GC diagnosis. Aspirin use was defined as ≥once weekly use. Subjects who failed HP eradication or diagnosed with GC within 12 months of HP therapy were excluded. The hazard ratio (HR) of GC with aspirin use was calculated by Cox model with propensity score adjustment for age, sex, comorbidities and concurrent medications. All statistical tests were two-sided. Results: The median follow-up was 7.6 years (IQR: 5.1-10.3 years), and 169 (0.27%) out of 63,605 patients developed GC. The incidence rate of GC was 3.5 per 10,000 person-years. Aspirin use was associated with a reduced GC risk (HR 0.30, 95% CI: 0.15-0.61). The risk of GC decreased with increasing frequency, duration and dose of aspirin (all p-trend <0.001). Conclusions: Aspirin use was associated with a frequency-, dose- and duration-dependent reduction in GC risk after HP eradication. The effect was most prominent in those who used aspirin daily or for ≥ 5 years.
| Type: | Article |
|---|---|
| Title: | Aspirin and Risk of Gastric Cancer After Helicobacter pylori Eradication: A Territory-Wide Study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/jnci/djx267 |
| Publisher version: | https://doi.org/10.1093/jnci/djx267 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | aspirin, stomach cancer, gastric adenocarcinoma, H. pylori |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10038317 |
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