Association of Daily Aspirin Therapy With Hepatocellular Carcinoma Risk in Patients With Chronic Hepatitis C Virus Infection

Aspirin therapy has been associated with reduced risk of colon cancer, but there is only limited evidence for its effects on risk of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. In this coh...

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Veröffentlicht in:Clinical gastroenterology and hepatology 2020-11, Vol.18 (12), p.2784-2792.e7
Hauptverfasser: Lee, Teng-Yu, Hsu, Yao-Chun, Tseng, Hsiao-Ching, Lin, Jaw-Town, Wu, Ming-Shiang, Wu, Chun-Ying
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container_end_page 2792.e7
container_issue 12
container_start_page 2784
container_title Clinical gastroenterology and hepatology
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creator Lee, Teng-Yu
Hsu, Yao-Chun
Tseng, Hsiao-Ching
Lin, Jaw-Town
Wu, Ming-Shiang
Wu, Chun-Ying
description Aspirin therapy has been associated with reduced risk of colon cancer, but there is only limited evidence for its effects on risk of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. In this cohort study, based on Taiwan’s National Health Insurance Research Database, we screened 237,963 patients with chronic HCV infection for the period of 1997 through 2011. We excluded patients with confounding conditions and 2478 patients who continuously received daily aspirin therapy for 90 days or more (treated group) were randomly matched 1:2 with 4956 patients who had never received antiplatelet therapy (untreated group) by means of propensity scores. Cumulative incidence of, and hazard ratio (HR) for, HCC development were analyzed after we adjusted for patient mortality as a competing risk event. The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group over 5 years (4.67%; 95% CI, 3.74%–5.59% vs 7.32%; 95% CI, 6.33%–8.30%; P
doi_str_mv 10.1016/j.cgh.2020.04.036
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We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. In this cohort study, based on Taiwan’s National Health Insurance Research Database, we screened 237,963 patients with chronic HCV infection for the period of 1997 through 2011. We excluded patients with confounding conditions and 2478 patients who continuously received daily aspirin therapy for 90 days or more (treated group) were randomly matched 1:2 with 4956 patients who had never received antiplatelet therapy (untreated group) by means of propensity scores. Cumulative incidence of, and hazard ratio (HR) for, HCC development were analyzed after we adjusted for patient mortality as a competing risk event. The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group over 5 years (4.67%; 95% CI, 3.74%–5.59% vs 7.32%; 95% CI, 6.33%–8.30%; P&lt;.001). In the multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR, 0.78, 95% CI, 0.64–0.95; P = .011), after adjustment for age per year, male sex, cirrhosis, liver decompensation, hyperlipidemia, statin use, and interferon therapy. Sensitivity subgroup analyses also verified this association (all HRs&lt;1.0). In addition, older age (HR, 1.03 per year; 95% CI, 1.02–1.04), male sex (HR, 1.46; 95% CI, 1.21–1.77), and cirrhosis (HR, 3.13; 95% CI, 2.55–3.84) were independently associated with an increased HCC risk. In a nationwide cohort study in Taiwan, we found aspirin therapy to be significantly associated with a reduced risk of HCV-related HCC.</description><identifier>ISSN: 1542-3565</identifier><identifier>EISSN: 1542-7714</identifier><identifier>DOI: 10.1016/j.cgh.2020.04.036</identifier><identifier>PMID: 32360983</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Asia ; Inflammation ; Liver Cancer ; Population</subject><ispartof>Clinical gastroenterology and hepatology, 2020-11, Vol.18 (12), p.2784-2792.e7</ispartof><rights>2020 AGA Institute</rights><rights>Copyright © 2020 AGA Institute. Published by Elsevier Inc. 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We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. In this cohort study, based on Taiwan’s National Health Insurance Research Database, we screened 237,963 patients with chronic HCV infection for the period of 1997 through 2011. We excluded patients with confounding conditions and 2478 patients who continuously received daily aspirin therapy for 90 days or more (treated group) were randomly matched 1:2 with 4956 patients who had never received antiplatelet therapy (untreated group) by means of propensity scores. Cumulative incidence of, and hazard ratio (HR) for, HCC development were analyzed after we adjusted for patient mortality as a competing risk event. The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group over 5 years (4.67%; 95% CI, 3.74%–5.59% vs 7.32%; 95% CI, 6.33%–8.30%; P&lt;.001). In the multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR, 0.78, 95% CI, 0.64–0.95; P = .011), after adjustment for age per year, male sex, cirrhosis, liver decompensation, hyperlipidemia, statin use, and interferon therapy. Sensitivity subgroup analyses also verified this association (all HRs&lt;1.0). In addition, older age (HR, 1.03 per year; 95% CI, 1.02–1.04), male sex (HR, 1.46; 95% CI, 1.21–1.77), and cirrhosis (HR, 3.13; 95% CI, 2.55–3.84) were independently associated with an increased HCC risk. 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We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. In this cohort study, based on Taiwan’s National Health Insurance Research Database, we screened 237,963 patients with chronic HCV infection for the period of 1997 through 2011. We excluded patients with confounding conditions and 2478 patients who continuously received daily aspirin therapy for 90 days or more (treated group) were randomly matched 1:2 with 4956 patients who had never received antiplatelet therapy (untreated group) by means of propensity scores. Cumulative incidence of, and hazard ratio (HR) for, HCC development were analyzed after we adjusted for patient mortality as a competing risk event. The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group over 5 years (4.67%; 95% CI, 3.74%–5.59% vs 7.32%; 95% CI, 6.33%–8.30%; P&lt;.001). In the multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR, 0.78, 95% CI, 0.64–0.95; P = .011), after adjustment for age per year, male sex, cirrhosis, liver decompensation, hyperlipidemia, statin use, and interferon therapy. Sensitivity subgroup analyses also verified this association (all HRs&lt;1.0). In addition, older age (HR, 1.03 per year; 95% CI, 1.02–1.04), male sex (HR, 1.46; 95% CI, 1.21–1.77), and cirrhosis (HR, 3.13; 95% CI, 2.55–3.84) were independently associated with an increased HCC risk. In a nationwide cohort study in Taiwan, we found aspirin therapy to be significantly associated with a reduced risk of HCV-related HCC.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32360983</pmid><doi>10.1016/j.cgh.2020.04.036</doi><orcidid>https://orcid.org/0000-0003-4207-2312</orcidid></addata></record>
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Inflammation
Liver Cancer
Population
title Association of Daily Aspirin Therapy With Hepatocellular Carcinoma Risk in Patients With Chronic Hepatitis C Virus Infection
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