Association between aspirin use and lung cancer incidence depends on high-frequency use, bodyweight, and age in U.S. adults

Xuesi Dong; Jieyu He; Lijuan Lin; Ying Zhu; Chao Chen; Li Su; Yang Zhao; Ruyang Zhang; Yongyue Wei; Feng Chen; David C Christiani

doi:10.21037/tlcr-20-414

Association between aspirin use and lung cancer incidence depends on high-frequency use, bodyweight, and age in U.S. adults

Transl Lung Cancer Res. 2021 Jan;10(1):392-401. doi: 10.21037/tlcr-20-414.

Authors

Xuesi Dong^{1

2

3

4}, Jieyu He^{1

3}, Lijuan Lin^{1

2

3}, Ying Zhu^{1

3}, Chao Chen^{1

3}, Li Su^{2

5}, Yang Zhao^{1

2

3

6}, Ruyang Zhang^{1

2

3

6}, Yongyue Wei^{1

2

3

7}, Feng Chen^{1

3

8

9}, David C Christiani^{2

5}

Affiliations

¹ Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
² Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China.
⁴ Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China.
⁵ Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁶ Department of Medical Oncology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
⁷ China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China.
⁸ State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.
⁹ Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Cancer Center, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.

Abstract

Background: Chemoprevention of cancer with aspirin is controversial as a primary prevention strategy. We sought to investigate the association between aspirin frequency and risk of lung cancer in The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

Methods: Using data from 101,722 participants in PLCO, we used a Cox regression model coupling with propensity score to detect the association between aspirin frequency and lung cancer risk.

Results: High-frequency aspirin use significantly increased risk of lung cancer by 28% compared to no use (HR =1.28; 95% CI, 1.14-1.45; P=3.37×10^-5), especially for current smoker (HR =1.30; 95% CI, 1.07-1.57; P=6.82×10^-3). However, the increased lung cancer risk due to high-frequency aspirin use significantly decreased with increasing bodyweight (HR_interaction =0.96; 95% CI, 0.94-0.99; P=1.26×10^-2). Further, for participants with bodyweight <80 kg, high-frequency aspirin use showed an elevated risk at <76 years of age (HR_age<76 =1.47; 95% CI, 1.25-1.73; P=3.81×10^-6). Our study used propensity score under various confounding and stratification analyses by cardio-cerebrovascular status, which all presented similar evidences.

Conclusions: High-frequency aspirin use is associated with the increased risk of lung cancer. Current smoker or people with age <76 years and bodyweight <80 kg should be more cautious to high-frequency aspirin use for lung cancer chemoprevention. This study provides a new insight for lung cancer chemoprevention.

Keywords: Aspirin; age; bodyweight; lung cancer; risk.

Abstract

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