Modification of the Associations Between Aspirin Use and Colorectal, Ovarian, Endometrial, Breast, and Prostate Cancer Risk
Principal Investigator
Name
Lauren Hurwitz
Degrees
PhD, MHS
Institution
National Cancer Institute
Position Title
Postdoctoral Fellow
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-403
Initial CDAS Request Approval
Oct 4, 2018
Title
Modification of the Associations Between Aspirin Use and Colorectal, Ovarian, Endometrial, Breast, and Prostate Cancer Risk
Summary
Aspirin is widely used for treatment of pain, fever, and inflammation, and may be used regularly for prevention of cardiovascular disease (CVD). Currently, the United States Preventive Services Task Force (USPSTF) recommends daily low-dose aspirin for individuals ages 50-60 with a 10-year risk of CVD of 10% or greater, for whom the benefits of daily aspirin most clearly outweigh potential harms.
A growing body of literature indicates that aspirin may also play a role in cancer prevention. Specifically, there is strong evidence from randomized clinical trials that regular aspirin use decreases risk of colorectal cancer and accumulating evidence from observational studies that aspirin may decrease risk of ovarian, endometrial, breast, and prostate cancer. Aspirin is thought to mitigate cancer risk via anti-inflammatory and antiplatelet mechanisms.
Currently, a major gap in the literature includes whether benefits of aspirin pertaining to cancer prevention are most evident in certain subpopulations. Aspirin use might potentially interact with other modifiable cancer risk factors that are thought to act through inflammatory pathways, such as body mass index, cigarette smoking, and physical activity. Aspirin use might also differentially impact cancer risk in individuals with a positive family history of cancer. Associations within subgroups defined by these risk factors are currently unknown but are needed to allow recommendations to be tailored to the groups most likely to benefit.
To address this gap, we propose to examine regular aspirin use and risk of colorectal, ovarian, endometrial, breast, and prostate cancer in the PLCO Screening Trial. Specifically, we aim to assess whether associations for aspirin and cancer risk vary by other modifiable lifestyle factors, such as body mass index, cigarette smoking, and physical activity, and by family history of cancer. To increase our power to detect effect modification, we propose to pool the PLCO data with data from the NIH-AARP study. Pooling these two cohorts to pursue these questions is ideal, as these cohorts enrolled large numbers of participants, collected similar information on aspirin use and the effect modifiers of interest, and enrolled individuals from the same age range and calendar period.
By presenting associations by cancer type and lifestyle factors in a single paper, we will enable clinicians, researchers, and individuals to understand and compare these risks within one paper. Ultimately, we hope to contribute toward a body of literature that will facilitate more precise risk-benefit calculations for aspirin use so that recommendations can be tailored accordingly.
A growing body of literature indicates that aspirin may also play a role in cancer prevention. Specifically, there is strong evidence from randomized clinical trials that regular aspirin use decreases risk of colorectal cancer and accumulating evidence from observational studies that aspirin may decrease risk of ovarian, endometrial, breast, and prostate cancer. Aspirin is thought to mitigate cancer risk via anti-inflammatory and antiplatelet mechanisms.
Currently, a major gap in the literature includes whether benefits of aspirin pertaining to cancer prevention are most evident in certain subpopulations. Aspirin use might potentially interact with other modifiable cancer risk factors that are thought to act through inflammatory pathways, such as body mass index, cigarette smoking, and physical activity. Aspirin use might also differentially impact cancer risk in individuals with a positive family history of cancer. Associations within subgroups defined by these risk factors are currently unknown but are needed to allow recommendations to be tailored to the groups most likely to benefit.
To address this gap, we propose to examine regular aspirin use and risk of colorectal, ovarian, endometrial, breast, and prostate cancer in the PLCO Screening Trial. Specifically, we aim to assess whether associations for aspirin and cancer risk vary by other modifiable lifestyle factors, such as body mass index, cigarette smoking, and physical activity, and by family history of cancer. To increase our power to detect effect modification, we propose to pool the PLCO data with data from the NIH-AARP study. Pooling these two cohorts to pursue these questions is ideal, as these cohorts enrolled large numbers of participants, collected similar information on aspirin use and the effect modifiers of interest, and enrolled individuals from the same age range and calendar period.
By presenting associations by cancer type and lifestyle factors in a single paper, we will enable clinicians, researchers, and individuals to understand and compare these risks within one paper. Ultimately, we hope to contribute toward a body of literature that will facilitate more precise risk-benefit calculations for aspirin use so that recommendations can be tailored accordingly.
Aims
To evaluate whether associations between aspirin use and risk of colorectal, ovarian, endometrial, breast, and prostate cancer are modified by body mass index, cigarette smoking, physical activity, and family history of cancer.
Collaborators
Britton Trabert, National Cancer Institute