Colorectal polyp prevention by daily aspirin use is abrogated among active smokers
Purpose Based on suggestive findings from a recent study of high-risk Japanese patients, we sought to determine whether the risk of colorectal polyps associated with smoking may be modified by daily use of aspirin in an analysis of a large US screening population. Methods This is a cross-sectional s...
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| Veröffentlicht in: | Cancer causes & control 2016-01, Vol.27 (1), p.93-103 |
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| creator | Drew, David A. Goh, Gyuhyeong Mo, Allen Grady, James J. Forouhar, Faripour Egan, Gretchen Swede, Helen Rosenberg, Daniel W. Stevens, Richard G. Devers, Thomas J. |
| description | Purpose
Based on suggestive findings from a recent study of high-risk Japanese patients, we sought to determine whether the risk of colorectal polyps associated with smoking may be modified by daily use of aspirin in an analysis of a large US screening population.
Methods
This is a cross-sectional study of 2,918 consecutive colonoscopy patients at a university hospital over a 30-month period. Data were abstracted from electronic medical records. Multivariate models of polyp counts were used to examine the competing risks of smoking and aspirin use. Models were further stratified by polyp location (proximal vs. distal) and pathologic subtype (dysplastic vs. serrated).
Results
Incidental rate of polyps was higher among active smokers [incidence rate ratio (IRR) 1.72; 95 % confidence interval (CI) 1.46–2.02] and lower among daily aspirin users (IRR 0.73; 95 % CI 0.61–0.86) compared to those who used neither. Smoking interacts significantly with aspirin use resulting in loss of aspirin protection (IRR 1.69; 95 % CI 1.28–2.24). Stratified analyses demonstrate that aspirin specifically reduces the risk of traditional dysplastic adenomas (IRR 0.72; 95 % CI 0.61–0.86) not serrated/hyperplastic polyps (IRR 0.92; 95 % CI 0.72–1.17) and that the modification of aspirin protection by smoking is primarily observed within the distal colorectum (
p
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| doi_str_mv | 10.1007/s10552-015-0686-1 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1760901228</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48691765</jstor_id><sourcerecordid>48691765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c464t-187d5c022f27db5f0ceeb38e8e89d67cd19d8422c96c8e9a3bcac6d50f54666c3</originalsourceid><addsrcrecordid>eNp9kMFq3DAURUVoSSZpP6CLBkE32Th9kizZWpYhTQKBQGnXQpaeB09ty5HswPx9FZyGkEXQ4i107n3SIeQLg0sGUH1PDKTkBTBZgKpVwY7IhslKFBXn8gPZgJZVIXkpTshpSnsAkIrDMTnhSjLQQmzIr23oQ0Q3255OoT9MdIr4iOPchZE2B-pt1x-oTVMXu5EuCWmXqG1i2NkZPbVDGHfUurl7RJqG8Bdj-kQ-trZP-Pl5npE_P69-b2-Ku_vr2-2Pu8KVqpwLVldeOuC85ZVvZAsOsRE15qO9qpxn2tcl504rV6O2onHWKS-hlaVSyokzcrH2TjE8LJhmM3TJYd_bEcOSDKsUaGCc1xn99gbdhyWO-XWZkkLLEkqRKbZSLoaUIrZmit1g48EwME_CzSrcZOHmSbhhOXP-3Lw0A_qXxH_DGeArkPLVuMP4avU7rV_X0D7NIb6UlrXS-VdS_AMihZTp</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1753954043</pqid></control><display><type>article</type><title>Colorectal polyp prevention by daily aspirin use is abrogated among active smokers</title><source>MEDLINE</source><source>JSTOR Archive Collection A-Z Listing</source><source>SpringerLink Journals - AutoHoldings</source><creator>Drew, David A. ; Goh, Gyuhyeong ; Mo, Allen ; Grady, James J. ; Forouhar, Faripour ; Egan, Gretchen ; Swede, Helen ; Rosenberg, Daniel W. ; Stevens, Richard G. ; Devers, Thomas J.</creator><creatorcontrib>Drew, David A. ; Goh, Gyuhyeong ; Mo, Allen ; Grady, James J. ; Forouhar, Faripour ; Egan, Gretchen ; Swede, Helen ; Rosenberg, Daniel W. ; Stevens, Richard G. ; Devers, Thomas J.</creatorcontrib><description>Purpose
Based on suggestive findings from a recent study of high-risk Japanese patients, we sought to determine whether the risk of colorectal polyps associated with smoking may be modified by daily use of aspirin in an analysis of a large US screening population.
Methods
This is a cross-sectional study of 2,918 consecutive colonoscopy patients at a university hospital over a 30-month period. Data were abstracted from electronic medical records. Multivariate models of polyp counts were used to examine the competing risks of smoking and aspirin use. Models were further stratified by polyp location (proximal vs. distal) and pathologic subtype (dysplastic vs. serrated).
Results
Incidental rate of polyps was higher among active smokers [incidence rate ratio (IRR) 1.72; 95 % confidence interval (CI) 1.46–2.02] and lower among daily aspirin users (IRR 0.73; 95 % CI 0.61–0.86) compared to those who used neither. Smoking interacts significantly with aspirin use resulting in loss of aspirin protection (IRR 1.69; 95 % CI 1.28–2.24). Stratified analyses demonstrate that aspirin specifically reduces the risk of traditional dysplastic adenomas (IRR 0.72; 95 % CI 0.61–0.86) not serrated/hyperplastic polyps (IRR 0.92; 95 % CI 0.72–1.17) and that the modification of aspirin protection by smoking is primarily observed within the distal colorectum (
p
< 0.03).
Conclusions
We report for the first time, in a typical risk US clinical population, a lack of protective association of aspirin for polyps among active smokers. Future prospective studies are recommended to confirm this mitigating effect in order to improve the precision of the growing evidence base about the chemopreventive benefit of aspirin in colorectal cancer.</description><identifier>ISSN: 0957-5243</identifier><identifier>EISSN: 1573-7225</identifier><identifier>DOI: 10.1007/s10552-015-0686-1</identifier><identifier>PMID: 26510933</identifier><identifier>CODEN: CCCNEN</identifier><language>eng</language><publisher>Cham: Springer Science + Business Media</publisher><subject>Aged ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Aspirin ; Aspirin - therapeutic use ; Biomedical and Life Sciences ; Biomedicine ; Cancer Research ; Colonic Polyps - epidemiology ; Colonic Polyps - prevention & control ; Colonoscopy ; Colorectal cancer ; Cross-Sectional Studies ; Electronic health records ; Endoscopy ; Epidemiology ; Female ; Hematology ; Humans ; Incidence ; Male ; Medical records ; Middle Aged ; Oncology ; ORIGINAL PAPER ; Patients ; Polyps ; Prevention ; Prospective Studies ; Public Health ; Risk ; Smoking</subject><ispartof>Cancer causes & control, 2016-01, Vol.27 (1), p.93-103</ispartof><rights>Springer International Publishing Switzerland 2015</rights><rights>Springer International Publishing Switzerland 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-187d5c022f27db5f0ceeb38e8e89d67cd19d8422c96c8e9a3bcac6d50f54666c3</citedby><cites>FETCH-LOGICAL-c464t-187d5c022f27db5f0ceeb38e8e89d67cd19d8422c96c8e9a3bcac6d50f54666c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48691765$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48691765$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27924,27925,41488,42557,51319,58017,58250</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26510933$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Drew, David A.</creatorcontrib><creatorcontrib>Goh, Gyuhyeong</creatorcontrib><creatorcontrib>Mo, Allen</creatorcontrib><creatorcontrib>Grady, James J.</creatorcontrib><creatorcontrib>Forouhar, Faripour</creatorcontrib><creatorcontrib>Egan, Gretchen</creatorcontrib><creatorcontrib>Swede, Helen</creatorcontrib><creatorcontrib>Rosenberg, Daniel W.</creatorcontrib><creatorcontrib>Stevens, Richard G.</creatorcontrib><creatorcontrib>Devers, Thomas J.</creatorcontrib><title>Colorectal polyp prevention by daily aspirin use is abrogated among active smokers</title><title>Cancer causes & control</title><addtitle>Cancer Causes Control</addtitle><addtitle>Cancer Causes Control</addtitle><description>Purpose
Based on suggestive findings from a recent study of high-risk Japanese patients, we sought to determine whether the risk of colorectal polyps associated with smoking may be modified by daily use of aspirin in an analysis of a large US screening population.
Methods
This is a cross-sectional study of 2,918 consecutive colonoscopy patients at a university hospital over a 30-month period. Data were abstracted from electronic medical records. Multivariate models of polyp counts were used to examine the competing risks of smoking and aspirin use. Models were further stratified by polyp location (proximal vs. distal) and pathologic subtype (dysplastic vs. serrated).
Results
Incidental rate of polyps was higher among active smokers [incidence rate ratio (IRR) 1.72; 95 % confidence interval (CI) 1.46–2.02] and lower among daily aspirin users (IRR 0.73; 95 % CI 0.61–0.86) compared to those who used neither. Smoking interacts significantly with aspirin use resulting in loss of aspirin protection (IRR 1.69; 95 % CI 1.28–2.24). Stratified analyses demonstrate that aspirin specifically reduces the risk of traditional dysplastic adenomas (IRR 0.72; 95 % CI 0.61–0.86) not serrated/hyperplastic polyps (IRR 0.92; 95 % CI 0.72–1.17) and that the modification of aspirin protection by smoking is primarily observed within the distal colorectum (
p
< 0.03).
Conclusions
We report for the first time, in a typical risk US clinical population, a lack of protective association of aspirin for polyps among active smokers. Future prospective studies are recommended to confirm this mitigating effect in order to improve the precision of the growing evidence base about the chemopreventive benefit of aspirin in colorectal cancer.</description><subject>Aged</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</subject><subject>Aspirin</subject><subject>Aspirin - therapeutic use</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cancer Research</subject><subject>Colonic Polyps - epidemiology</subject><subject>Colonic Polyps - prevention & control</subject><subject>Colonoscopy</subject><subject>Colorectal cancer</subject><subject>Cross-Sectional Studies</subject><subject>Electronic health records</subject><subject>Endoscopy</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>ORIGINAL PAPER</subject><subject>Patients</subject><subject>Polyps</subject><subject>Prevention</subject><subject>Prospective Studies</subject><subject>Public Health</subject><subject>Risk</subject><subject>Smoking</subject><issn>0957-5243</issn><issn>1573-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kMFq3DAURUVoSSZpP6CLBkE32Th9kizZWpYhTQKBQGnXQpaeB09ty5HswPx9FZyGkEXQ4i107n3SIeQLg0sGUH1PDKTkBTBZgKpVwY7IhslKFBXn8gPZgJZVIXkpTshpSnsAkIrDMTnhSjLQQmzIr23oQ0Q3255OoT9MdIr4iOPchZE2B-pt1x-oTVMXu5EuCWmXqG1i2NkZPbVDGHfUurl7RJqG8Bdj-kQ-trZP-Pl5npE_P69-b2-Ku_vr2-2Pu8KVqpwLVldeOuC85ZVvZAsOsRE15qO9qpxn2tcl504rV6O2onHWKS-hlaVSyokzcrH2TjE8LJhmM3TJYd_bEcOSDKsUaGCc1xn99gbdhyWO-XWZkkLLEkqRKbZSLoaUIrZmit1g48EwME_CzSrcZOHmSbhhOXP-3Lw0A_qXxH_DGeArkPLVuMP4avU7rV_X0D7NIb6UlrXS-VdS_AMihZTp</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Drew, David A.</creator><creator>Goh, Gyuhyeong</creator><creator>Mo, Allen</creator><creator>Grady, James J.</creator><creator>Forouhar, Faripour</creator><creator>Egan, Gretchen</creator><creator>Swede, Helen</creator><creator>Rosenberg, Daniel W.</creator><creator>Stevens, Richard G.</creator><creator>Devers, Thomas J.</creator><general>Springer Science + Business Media</general><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Colorectal polyp prevention by daily aspirin use is abrogated among active smokers</title><author>Drew, David A. ; Goh, Gyuhyeong ; Mo, Allen ; Grady, James J. ; Forouhar, Faripour ; Egan, Gretchen ; Swede, Helen ; Rosenberg, Daniel W. ; Stevens, Richard G. ; Devers, Thomas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-187d5c022f27db5f0ceeb38e8e89d67cd19d8422c96c8e9a3bcac6d50f54666c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</topic><topic>Aspirin</topic><topic>Aspirin - therapeutic use</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cancer Research</topic><topic>Colonic Polyps - epidemiology</topic><topic>Colonic Polyps - prevention & control</topic><topic>Colonoscopy</topic><topic>Colorectal cancer</topic><topic>Cross-Sectional Studies</topic><topic>Electronic health records</topic><topic>Endoscopy</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>ORIGINAL PAPER</topic><topic>Patients</topic><topic>Polyps</topic><topic>Prevention</topic><topic>Prospective Studies</topic><topic>Public Health</topic><topic>Risk</topic><topic>Smoking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Drew, David A.</creatorcontrib><creatorcontrib>Goh, Gyuhyeong</creatorcontrib><creatorcontrib>Mo, Allen</creatorcontrib><creatorcontrib>Grady, James J.</creatorcontrib><creatorcontrib>Forouhar, Faripour</creatorcontrib><creatorcontrib>Egan, Gretchen</creatorcontrib><creatorcontrib>Swede, Helen</creatorcontrib><creatorcontrib>Rosenberg, Daniel W.</creatorcontrib><creatorcontrib>Stevens, Richard G.</creatorcontrib><creatorcontrib>Devers, Thomas J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer causes & control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Drew, David A.</au><au>Goh, Gyuhyeong</au><au>Mo, Allen</au><au>Grady, James J.</au><au>Forouhar, Faripour</au><au>Egan, Gretchen</au><au>Swede, Helen</au><au>Rosenberg, Daniel W.</au><au>Stevens, Richard G.</au><au>Devers, Thomas J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Colorectal polyp prevention by daily aspirin use is abrogated among active smokers</atitle><jtitle>Cancer causes & control</jtitle><stitle>Cancer Causes Control</stitle><addtitle>Cancer Causes Control</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>27</volume><issue>1</issue><spage>93</spage><epage>103</epage><pages>93-103</pages><issn>0957-5243</issn><eissn>1573-7225</eissn><coden>CCCNEN</coden><abstract>Purpose
Based on suggestive findings from a recent study of high-risk Japanese patients, we sought to determine whether the risk of colorectal polyps associated with smoking may be modified by daily use of aspirin in an analysis of a large US screening population.
Methods
This is a cross-sectional study of 2,918 consecutive colonoscopy patients at a university hospital over a 30-month period. Data were abstracted from electronic medical records. Multivariate models of polyp counts were used to examine the competing risks of smoking and aspirin use. Models were further stratified by polyp location (proximal vs. distal) and pathologic subtype (dysplastic vs. serrated).
Results
Incidental rate of polyps was higher among active smokers [incidence rate ratio (IRR) 1.72; 95 % confidence interval (CI) 1.46–2.02] and lower among daily aspirin users (IRR 0.73; 95 % CI 0.61–0.86) compared to those who used neither. Smoking interacts significantly with aspirin use resulting in loss of aspirin protection (IRR 1.69; 95 % CI 1.28–2.24). Stratified analyses demonstrate that aspirin specifically reduces the risk of traditional dysplastic adenomas (IRR 0.72; 95 % CI 0.61–0.86) not serrated/hyperplastic polyps (IRR 0.92; 95 % CI 0.72–1.17) and that the modification of aspirin protection by smoking is primarily observed within the distal colorectum (
p
< 0.03).
Conclusions
We report for the first time, in a typical risk US clinical population, a lack of protective association of aspirin for polyps among active smokers. Future prospective studies are recommended to confirm this mitigating effect in order to improve the precision of the growing evidence base about the chemopreventive benefit of aspirin in colorectal cancer.</abstract><cop>Cham</cop><pub>Springer Science + Business Media</pub><pmid>26510933</pmid><doi>10.1007/s10552-015-0686-1</doi><tpages>11</tpages></addata></record> |
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| ispartof | Cancer causes & control, 2016-01, Vol.27 (1), p.93-103 |
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| source | MEDLINE; JSTOR Archive Collection A-Z Listing; SpringerLink Journals - AutoHoldings |
| subjects | Aged Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Aspirin Aspirin - therapeutic use Biomedical and Life Sciences Biomedicine Cancer Research Colonic Polyps - epidemiology Colonic Polyps - prevention & control Colonoscopy Colorectal cancer Cross-Sectional Studies Electronic health records Endoscopy Epidemiology Female Hematology Humans Incidence Male Medical records Middle Aged Oncology ORIGINAL PAPER Patients Polyps Prevention Prospective Studies Public Health Risk Smoking |
| title | Colorectal polyp prevention by daily aspirin use is abrogated among active smokers |
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