Aspirin Use and Prostate Cancer among African-American Men in the Southern Community Cohort Study
Wei Tang, Jay H Fowke, Lauren M Hurwitz, Mark Steinwandel, William J Blot, Stefan Ambs
Cancer Epidemiology and Prevention Biomarkers 30 (3), 539-544, 2021
Background:
The association of aspirin use with prostate cancer has been investigated, but few studies included African-American men. Here, we analyzed the relationship of aspirin intake with prostate cancer risk and mortality among African-American men in the Southern Community Cohort Study (SCCS).
Methods:
SCCS recruited 22,426 African-American men between 2002 and 2009. Aspirin use was assessed at enrollment. Our exposures of interest were any aspirin use (regular strength, low-dose or baby aspirin, or half tablets of aspirin) and regular strength aspirin. Each exposure variable was compared with nonusers. Associations between aspirin use and prostate cancer risk and mortality were examined with Cox proportional hazards models.
Results:
At enrollment, 5,486 men (25.1%) reported taking any aspirin and 2,634 men (12.1%) reported regular strength aspirin use. During follow-up (median, 13 years), 1,058 men developed prostate cancer, including 103 prostate cancer–specific deaths. Aspirin use was not associated with prostate cancer development [adjusted HR, 1.07; 95% confidence interval (CI), 0.92–1.25 for any aspirin use and HR, 0.97; 95% CI, 0.78–1.19 for regular strength aspirin], but was suggestively associated with reduced prostate cancer mortality (HR, 0.66; 95% CI, 0.39–1.14 for any aspirin use and HR, 0.41; 95% CI, 0.17–1.00 for regular strength aspirin).
Conclusions:
Aspirin use at enrollment was tentatively associated with reduced prostate cancer mortality, but not risk, among African-American men in SCCS.
Impact:
Prospective SCCS data suggest that aspirin use may help prevent lethal prostate cancer among this high-risk group of men
Written by
Graham49
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This earlier study does not differentiate between race. There is a clinical trial in progress. Of course there is an increased risk of bleeding with taking aspirin.
Regular Aspirin Use and the Risk of Lethal Prostate Cancer in the Physicians’ Health Study
Regular aspirin use probably protects against some malignancies including prostate cancer (PC), but its impact on lethal PC is particularly unclear.
Objective
To investigate the association between regular aspirin and (1) the risk of lethal PC in a large prospective cohort and (2) survival after PC diagnosis.
Design, setting, and participants
In 1981/82, the Physicians’ Health Study randomized 22 071 healthy male physicians to aspirin, β-carotene, both, or placebo. After the trial ended in 1988, annual questionnaires have obtained data on aspirin use, cancer diagnoses, and outcomes up to 2009 for the whole cohort, and to 2015 for PC patients.
Outcome measurements and statistical analysis
We evaluated the relationship between regular aspirin (>3 tablets/week) and lethal PC (metastases or PC death). Cox proportional-hazards models estimated hazard ratios (HRs) for the risk of lethal PC in the whole cohort and postdiagnosis survival among men initially diagnosed with nonlethal PC.
Results and limitations
Risk analysis revealed that 502 men developed lethal PC by 2009. Current and past regular aspirin was associated with a lower risk of lethal PC (current: HR 0.68, 95% confidence interval [CI] 0.52–0.89; past: HR 0.54, 95% CI 0.40–0.74) compared to never users. In the survival analysis, 407/3277 men diagnosed with nonlethal PC developed lethal disease by 2015. Current postdiagnostic aspirin was associated with lower risks of lethal PC (HR 0.68, 95% CI 0.52–0.90) and overall mortality (HR 0.72, 95% CI 0.61–0.9). We could not assess aspirin dose, and inconsistencies were observed in some sensitivity analyses.
Conclusions
Current regular aspirin use was associated with a lower risk of lethal PC among all participants. Current postdiagnostic use was associated with improved survival after diagnosis, consistent with a potential inhibitory effect of aspirin on PC progression. A randomized trial is warranted to confirm or refute these findings.
Patient summary
We examined the potential effect of regular aspirin use on lethal prostate cancer. We found that taking aspirin was associated with a lower risk of lethal prostate cancer, and taking it after diagnosis may help to prevent prostate cancer from becoming fatal.
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