Holli Loomans-Kropp

Ph.D., M.P.H.

The Ohio State University

Assistant Professor

PLCO (Learn more about this study)

PLCO-907

Feb 15, 2022

An evaluation of the association between aspirin and NSAID use and changes in body mass index on gastrointestinal cancer incidence and mortality

Obesity (BMI >=30) is a rising problem in the United States and globally. In the United States, it is estimated that approximately 42% of adults over age 20 are obese and this number continues to rise (1). For example, between 1999 and 2014, the prevalence of adult obesity in the United States increased by 7.2% (2). The growing prevalence of obesity is of great public health concern, as there are many negative health effects associated with these conditions, such as type 2 diabetes, heart disease, and cancer (3). The association between obesity and cancer, specifically gastrointestinal cancer, may be linked through the presence of chronic, low-level inflammation, which can induce DNA damage and oxidative stress (4). Therefore, reducing systemic chronic inflammation may reduce subsequent gastrointestinal cancer risk, which may be achieved through aspirin or nonsteroidal anti-inflammatory drug (NSAID) use, which has long been implicated in chemoprevention, with the strongest evidence presented for colorectal cancer prevention (5). However, there is little research evaluating the association between BMI, aspirin or NSAID use, and cancer risk (6). Furthermore, the relationship between changes in BMI over time, aspirin and NSAID use, and cancer risk remain relatively unexplored. Therefore, in this study, we propose to examine the association between BMI, aspirin and NSAID use, and cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trail.

Aim 1: To evaluate the association between aspirin and NSAID use and gastrointestinal cancer incidence, stratified by change in participant body mass index.
o Aim 1a: To evaluate the association between aspirin and NSAID use and individual gastrointestinal cancer (colorectal, esophageal, gastric, liver, pancreatic) incidence, stratified by change in participant body mass index.

Aim 2: To investigate the association between aspirin and NSAID use and gastrointestinal cancer-specific mortality, stratified by change in participant body mass index.
o Aim 2a: To investigate the association between aspirin and NSAID use and individual gastrointestinal cancer-specific (colorectal, esophageal, gastric, liver, pancreatic) mortality, stratified by change in participant body mass index.