TY - JOUR
T1 - Aspirin, Statins, Non-aspirin NSAIDs, Metformin, and the Risk of Biliary Cancer
T2 - A Swedish Population-Based Cohort Study
AU - Marcano-Bonilla, Lorena
AU - Schleck, Cathy D.
AU - Harmsen, William S.
AU - Sadr-Azodi, Omid
AU - Borad, Mitesh J.
AU - Patel, Tushar
AU - Petersen, Gloria M.
AU - Therneau, Terry M.
AU - Roberts, Lewis R.
AU - Brusselaers, Nele
N1 - Funding Information:
This work was supported by the NIH through the Mayo Clinic Center for Clinical and Translational Science (UL1 TR000135), the NCI through the Mayo Clinic Hepatobiliary SPORE Grant (P50 CA210964), the Women’s Health Research Center at Mayo Clinic, the Karolinska Institutet-Mayo Clinic Collaborative Travel Grant, The Cholangiocarcinoma Foundation, and the Strategic Funding in Epidemiology (SFO, Karolinska Institutet, Young Scholar Grant).
Funding Information:
T.M. Therneau reports grants from NIH during the conduct of the study. L.R. Roberts reports grants from NIH, Mayo Clinic, The Cholangiocarcinoma Foundation, Bayer, Boston Scientific, Exact Sciences, Fujifilm Medical Sciences, Gilead Sciences, Glycotest Inc, Redhill Biopharma, TARGET PharmaSolutions, and Karolinska Institutet during the conduct of the study as well as other support from MedEd Design LLC, Pontifax, Global Life Science Consulting, The Lynx Group, AstraZeneca, Bayer, Eisai, Exact Sciences, and GRAIL Inc outside the submitted work. No disclosures were reported by the other authors.
Publisher Copyright:
© 2022 American Association for Cancer Research.
PY - 2022/4
Y1 - 2022/4
N2 - Background: Chemoprevention for biliary tract cancers (BTC), which comprise intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcinoma (eCCA), and gallbladder cancer, is controversial. We examined associations between low-dose aspirin, statins, NSAIDs, and metformin with BTC risk. Methods: We used a population-based cohort of 5.7 million persons over age 18 without personal history of cancer (except nonmelanoma skin cancer), receiving at least one commonly prescribed drug between July 1, 2005, and December 31, 2012, from the Swedish Prescribed Drug Registry. Hazard ratios (HR) were calculated using age-scaled multivariable-adjusted Cox models. Results: 2,160 individuals developed BTC. Low-dose aspirin was not associated with BTC risk [HR, 0.93; 95% confidence interval (CI), 0.81-1.07], iCCA (HR, 1.21; 95% CI, 0.93-1.57), eCCA (HR, 0.80; 95% CI, 0.60-1.07), or gallbladder cancer (HR, 0.87; 95% CI, 0.71-1.06). Statins were associated with lower risk ofBTC (HR, 0.66; 95% CI, 0.56-0.78), iCCA (HR, 0.69; 95% CI, 0.50-0.95), eCCA (HR 0.54; 95% CI, 0.38-0.76), and gallbladder cancer (HR, 0.72; 95% CI, 0.57-0.91). For all BTC subtypes, combined low-dose aspirin and statinswere not associatedwithlower risk than statins alone.NSAIDs were associated with higher risk of BTC and its subtypes. Metformin was not associated with BTC risk (HR, 0.98; 95% CI, 0.82-1.18), iCCA (HR, 1.06; 95% CI, 0.77-1.48), eCCA (HR, 1.15; 95% CI, 0.82- 1.61), or gallbladder cancer (HR, 0.84; 95% CI, 0.63-1.11). Conclusions: Statins were associated with a decreased risk of BTC and its subtypes. Low-dose aspirin alone was not associated with a decreased risk, and use of both was not associated with further decrease in risk beyond statins alone.
AB - Background: Chemoprevention for biliary tract cancers (BTC), which comprise intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcinoma (eCCA), and gallbladder cancer, is controversial. We examined associations between low-dose aspirin, statins, NSAIDs, and metformin with BTC risk. Methods: We used a population-based cohort of 5.7 million persons over age 18 without personal history of cancer (except nonmelanoma skin cancer), receiving at least one commonly prescribed drug between July 1, 2005, and December 31, 2012, from the Swedish Prescribed Drug Registry. Hazard ratios (HR) were calculated using age-scaled multivariable-adjusted Cox models. Results: 2,160 individuals developed BTC. Low-dose aspirin was not associated with BTC risk [HR, 0.93; 95% confidence interval (CI), 0.81-1.07], iCCA (HR, 1.21; 95% CI, 0.93-1.57), eCCA (HR, 0.80; 95% CI, 0.60-1.07), or gallbladder cancer (HR, 0.87; 95% CI, 0.71-1.06). Statins were associated with lower risk ofBTC (HR, 0.66; 95% CI, 0.56-0.78), iCCA (HR, 0.69; 95% CI, 0.50-0.95), eCCA (HR 0.54; 95% CI, 0.38-0.76), and gallbladder cancer (HR, 0.72; 95% CI, 0.57-0.91). For all BTC subtypes, combined low-dose aspirin and statinswere not associatedwithlower risk than statins alone.NSAIDs were associated with higher risk of BTC and its subtypes. Metformin was not associated with BTC risk (HR, 0.98; 95% CI, 0.82-1.18), iCCA (HR, 1.06; 95% CI, 0.77-1.48), eCCA (HR, 1.15; 95% CI, 0.82- 1.61), or gallbladder cancer (HR, 0.84; 95% CI, 0.63-1.11). Conclusions: Statins were associated with a decreased risk of BTC and its subtypes. Low-dose aspirin alone was not associated with a decreased risk, and use of both was not associated with further decrease in risk beyond statins alone.
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U2 - 10.1158/1055-9965.EPI-20-1322
DO - 10.1158/1055-9965.EPI-20-1322
M3 - Article
C2 - 35086822
AN - SCOPUS:85128161415
SN - 1055-9965
VL - 31
SP - 804
EP - 810
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 4
ER -