Acetylsalicylic Acid Effect in Colorectal Cancer Taking into Account the Role of Tobacco, Alcohol and Excess Weight

Didac Florensa; Jordi Mateo; Francesc Solsona; Leonardo Galván; Miquel Mesas; Ramon Piñol; Leonardo Espinosa-Leal; Pere Godoy

doi:10.3390/ijerph20054104

Acetylsalicylic Acid Effect in Colorectal Cancer Taking into Account the Role of Tobacco, Alcohol and Excess Weight

Int J Environ Res Public Health. 2023 Feb 24;20(5):4104. doi: 10.3390/ijerph20054104.

Authors

Didac Florensa^{1

2}, Jordi Mateo¹, Francesc Solsona¹, Leonardo Galván³, Miquel Mesas⁴, Ramon Piñol⁵, Leonardo Espinosa-Leal⁶, Pere Godoy^{2

7

8}

Affiliations

¹ Department of Computer Engineering and Digital Design, University of Lleida, Jaume II 69, 25001 Lleida, Spain.
² Population Cancer Registry in Lleida, Santa Maria University Hospital, Av. Alcalde Rovira Roure 44, 25198 Lleida, Spain.
³ Pharmacy Unit, Catalan Health Service, Av. Alcalde Rovira Roure 2, 25006 Lleida, Spain.
⁴ SAP-Argos Department, Santa Maria University Hospital, Av. Alcalde Rovira Roure 44, 25198 Lleida, Spain.
⁵ Catalan Health Service, Department of Health, Av. Alcalde Rovira Roure 2, 25006 Lleida, Spain.
⁶ Graduate School and Research, Arcada University of Applied Science, Jan-Magnus Janssonin Aukio 1, 00550 Helsinki, Finland.
⁷ Lleida Biomedical Research Institute, Av. Alcalde Rovira Roure 80, 25198 Lleida, Spain.
⁸ CIBER Epidemiology and Public Health (CIBERESP), Health Institute Carlos III, 28029 Madrid, Spain.

Abstract

Excess weight, smoking and risky drinking are preventable risk factors for colorectal cancer (CRC). However, several studies have reported a protective association between aspirin and the risk of CRC. This article looks deeper into the relationships between risk factors and aspirin use with the risk of developing CRC. We performed a retrospective cohort study of CRC risk factors and aspirin use in persons aged >50 years in Lleida province. The participants were inhabitants with some medication prescribed between 2007 and 2016 that were linked to the Population-Based Cancer Registry to detect CRC diagnosed between 2012 and 2016. Risk factors and aspirin use were studied using the adjusted HR (aHR) with 95% confidence intervals (CI) using a Cox proportional hazard model. We included 154,715 inhabitants of Lleida (Spain) aged >50 years. Of patients with CRC, 62% were male (HR = 1.8; 95% CI: 1.6-2.2), 39.5% were overweight (HR = 2.8; 95% CI: 2.3-3.4) and 47.3% were obese (HR = 3.0; 95% CI: 2.6-3.6). Cox regression showed an association between aspirin and CRC (aHR = 0.7; 95% CI: 0.6-0.8), confirming a protective effect against CRC and an association between the risk of CRC and excess weight (aHR = 1.4; 95% CI: 1.2-1.7), smoking (aHR = 1.4; 95% CI: 1.3-1.7) and risky drinking (aHR = 1.6; 95% CI: 1.2-2.0). Our results show that aspirin use decreased the risk of CRC and corroborate the relationship between overweight, smoking and risky drinking and the risk of CRC.

Keywords: aspirin use; colorectal cancer; excess weight; risky drinking; smoking.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aspirin* / therapeutic use
Cohort Studies
Colorectal Neoplasms* / diagnosis
Ethanol
Female
Humans
Male
Overweight / complications
Retrospective Studies
Weight Gain

Substances

Aspirin
Ethanol

Grants and funding

This work was supported by contract 2019-DI-43 of the Industrial Doctorate Program of the Government of Catalonia. Project PID2020-113614RB-C22 was funded by the Spanish Ministry of Science and Innovation. Some authors are members of the 2014-SGR163 research group, funded by the Generalitat de Catalunya.