Evidence map›Paper›PMID 35717628›Full record

ArticleCancer medicine2023

Low-dose aspirin use and colorectal cancer survival in 32,195 patients-A national cohort study.

Mehrnoosh Shahrivar, Caroline E Weibull, Karin Ekström Smedby, Bengt Glimelius, Ingvar Syk, Peter Matthiessen, Caroline Nordenvall, Anna Martling

Abstract read
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mehrnoosh ShahrivarDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-1994-0361
Caroline E WeibullDepartment of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-8231-8183
Karin Ekström SmedbyDepartment of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.
Bengt GlimeliusDepartment of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Ingvar SykDepartment of Surgery, Skåne University Hospital, Malmö, Sweden.
Peter MatthiessenDepartment of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Caroline NordenvallDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Anna MartlingDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResults from previous studies indicate that use of aspirin may improve colorectal cancer (CRC) survival. The aim of this study was to assess whether use of aspirin influences overall survival or CRC-specific survival in an unselected cohort of patients diagnosed with CRC.

methodsThe study was performed using the Colorectal Cancer Data Base Sweden (CRCBaSe), a mega-linkage originating from the Swedish Colorectal Cancer Register, with additional linkages to other national health care registers. All patients diagnosed with primary CRC stage I-III treated with curative surgery, aged 18-85 years at diagnosis, from 2007 through 2016 were identified. Information on low-dose aspirin use was extracted from the Swedish Prescribed Drug Register. Exposure was defined as dispensed prescription for at least 6 months. Aspirin exposure was analyzed at the time of surgery (yes/no) and as a time-varying exposure during follow-up. Follow-up was restricted to a maximum 6 years, to model 5-year survival. Cox regression models were fitted to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Adjustments were performed for sex, age, year of diagnosis, Charlson comorbidity index, hypertension, and ASA score as potential confounders.

resultsA total of 32,195 patients diagnosed with CRC were included. 6764 (21%) were exposed to aspirin at the time of CRC surgery. The median time of follow-up was 4.2 years. Aspirin use at the time of surgery was not associated with all-cause (adjusted HR = 1.03, 95% CI: 0.97-1.08) nor CRC-specific mortality (adjusted HR = 0.99, 95% CI: 0.91-1.07). Aspirin use during follow-up was associated with increased all-cause (adjusted HR = 1.09, 95% CI: 1.04-1.15) but not CRC-specific mortality (adjusted HR = 0.98, 95% CI: 0.91-1.06). A CRC-specific effect associated with aspirin was noted from approximately 3 years following surgery.

conclusionsIn this large nation-wide cohort study there was no convincing association between aspirin use after CRC and OS or CRC-specific survival.

Indexed as

Colorectal NeoplasmsDigestive System Surgical ProceduresHypertensionAspirinCohort StudiesHumansAspirinaspirincolorectal cancerpharmacoepidemiologysurvival

Identifiers

PMID35717628
PMCPMC9844641

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.