Abstract

Purpose

Whether long-term aspirin usage is associated with colorectal cancer (CRC) risk needs more evidence. The study evaluated the association between long-term aspirin use and prevalence of CRC in a large, nationally representative database.

Methods

Hospitalized patients aged ≥ 50 years during 2018 were identified in the United States (US) National Inpatient Sample (NIS). Patients without complete information of age, sex, race, income, and insurance status were excluded, as well as those with inflammatory bowel disease (IBD) or malignancies other than CRC. Propensity score matching (PSM) was applied to balance the characteristics between patients with and without long-term aspirin use. Logistic regressions were performed to determine the relationship between long-term aspirin use and the presence of CRC. CRC and aspirin use were identified through the administrative International Classification of Diseases (ICD) codes.

Results

Data from 3,490,226 patients were included, in which 688,018 (19.7%) had a record of long-term aspirin use. After 1:1 PSM, there remained 1,376,006 patients, representing 6,880,029 individuals in the US after weighting. After adjusting for confounders, long-term aspirin use was significantly associated with lower CRC odds (adjusted odds ratio [aOR] = 0.64, 95% confidence interval [CI] 0.62, 0.67). This association was not changed when stratified by age, sex, race, body mass index (BMI), and smoking.

Conclusions

From a national inpatient dataset, US adults ≥ 50 years on long-term aspirin are less likely to have CRC, regardless of age, sex, race, BMI, and smoking status.

中文翻译：

---

长期使用阿司匹林对结直肠癌患病率的潜在有益影响：针对美国全国住院患者样本的一项基于人群的研究

摘要

目的

长期使用阿司匹林是否与结直肠癌（CRC）风险相关需要更多证据。该研究在一个具有全国代表性的大型数据库中评估了长期使用阿司匹林与结直肠癌患病率之间的关联。

方法

2018 年，美国 (US) 国家住院患者样本 (NIS) 中确定了年龄 ≥ 50 岁的住院患者。没有完整年龄、性别、种族、收入和保险状况信息的患者以及患有炎症性肠病 (IBD) 或除 CRC 以外的恶性肿瘤的患者被排除在外。应用倾向评分匹配（PSM）来平衡长期使用阿司匹林和未长期使用阿司匹林的患者之间的特征。进行逻辑回归以确定长期使用阿司匹林与结直肠癌之间的关系。 CRC 和阿司匹林的使用是通过国际疾病分类 (ICD) 管理代码进行识别的。

结果

纳入了 3,490,226 名患者的数据，其中 688,018 名患者（19.7%）有长期服用阿司匹林的记录。 1:1 PSM 后，加权后美国仍有 1,376,006 名患者，即 6,880,029 人。调整混杂因素后，长期使用阿司匹林与较低的 CRC 几率显着相关（调整后的几率 [aOR] = 0.64，95% 置信区间 [CI] 0.62，0.67）。当按年龄、性别、种族、体重指数（BMI）和吸烟进行分层时，这种关联性没有改变。

结论

根据全国住院患者数据，长期服用阿司匹林≥50岁的美国成年人患结直肠癌的可能性较小，无论年龄、性别、种族、体重指数和吸烟状况如何。