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Potential beneficial effects of long-term aspirin use on the prevalence of colorectal cancer: a population-based study of the US Nationwide Inpatient Sample

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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.

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Data availability

All data use to support the findings of this study are included within the article.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Ko-Chao Lee, Hong-Hwa Chen, Kung-Chuan Cheng & Kuen-Lin Wu

  2. Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Kuan-Chih Chung

  3. Division of Colon & Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan

    Ling-Chiao Song

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Contributions

K-CL and K-CC: conception and design; acquisition of data; analysis and interpretation of data; critical revision of the manuscript; final approval of the manuscript; drafting of the manuscript; definition of intellectual content; literature research; supervision. H-HC, K-CC, K-LW, and L-CS: Conception and design; Acquisition of data; Analysis and interpretation of data; Critical revision of the manuscript; Final approval of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kuan-Chih Chung.

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Conflict of interest

The authors declare no competing of interest.

Research involving human and animals participants

The study protocol was submitted to the Institutional Review Board (IRB) of Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, and the study was granted an exemption from IRB approval.

Informed consent

Due to the fact that all data in the NIS database is de-identified, informed consent was not required.

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Lee, KC., Chung, KC., Chen, HH. et al. Potential beneficial effects of long-term aspirin use on the prevalence of colorectal cancer: a population-based study of the US Nationwide Inpatient Sample. Cancer Causes Control 35, 477–486 (2024). https://doi.org/10.1007/s10552-023-01803-x

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  • DOI: https://doi.org/10.1007/s10552-023-01803-x

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