PDF(Pubmed)
Abstract：
Background Aspirin may reduce the risk of cancer, particularly gastrointestinal cancer, and venous thromboembolism (VTE). VTE can be the first symptom of occult cancer, but whether it is also a marker of occult cancer in aspirin users remains unknown. Therefore, we investigated the risk of cancer subsequent to VTE among users of low-dose aspirin. Methods We conducted a population-based cohort study using data from Danish health registries for the years 2001 to 2018. We identified all patients with a first-time diagnosis of VTE who also redeemed a prescription for low-dose aspirin (75-150mg) within 90 days prior to the first-time VTE. We categorized aspirin users by the number of prescriptions filled as new users (<5 prescriptions), short-term users (5-19 prescriptions), and long-term users (>19 prescriptions). We computed the absolute cancer risks and standardized incidence ratios (SIRs) for cancer using national cancer incidence rates. Results We followed-up 11,759 users of low-dose aspirin with VTE. Long-term users comprised 50% of aspirin users. The 1-year absolute risk of cancer was 6.0% for new users and 6.7% for short-term and long-term users, with corresponding SIRs of 3.3 (95% confidence interval [CI]: 2.8-4.0), 3.2 (95% CI: 2.9-3.7), and 2.8 (95% CI: 2.6-3.2), respectively. After the first year of follow-up, the SIR decreased to 1.2 (95% CI: 1.1-1.4) for new users, 1.1 (95% CI: 1.1-1.3) for short-term users, and 1.1 (95% CI: 1.0-1.2) for long-term users. Conclusion VTE may be a harbinger of cancer, even in users of low-dose aspirin, regardless of duration of use.
摘要：
背景：阿司匹林可以降低患癌症的风险，尤其是胃肠道癌，静脉血栓栓塞（VTE）。VTE可能是隐匿性癌症的首发症状，但是它是否也是阿司匹林使用者隐匿性癌症的标志仍然未知。因此,我们调查了低剂量阿司匹林患者VTE后癌症的风险.方法我们使用2001年至2018年丹麦卫生登记处的数据进行了一项基于人群的队列研究。我们确定了所有首次诊断为VTE的患者，这些患者还在首次VTE前90天内兑换了低剂量阿司匹林（75-150mg）的处方。我们根据新用户的处方数量（<5张处方）对阿司匹林使用者进行了分类，短期用户（5-19处方），和长期用户（>19处方）。我们使用国家癌症发病率计算了癌症的绝对癌症风险和标准化发病率（SIR）。结果我们随访了11,759名低剂量阿司匹林患者的VTE。长期使用者占阿司匹林使用者的50%。新用户1年的癌症绝对风险为6.0%,短期和长期用户为6.7%,相应的SIR为3.3（95%置信区间[CI]：2.8-4.0），3.2（95%CI：2.9-3.7），和2.8（95%CI：2.6-3.2），分别。经过第一年的随访，新用户的SIR降至1.2(95%CI：1.1-1.4)，短期用户1.1（95%CI：1.1-1.3），长期用户为1.1（95%CI：1.0-1.2）。结论VTE可能是肿瘤的先兆,即使是低剂量阿司匹林的使用者，无论使用时间如何。
