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Aspirin use and lung cancer risk: a possible relationship? Evidence from an updated meta-analysis.

Jiang HY, Huang TB, Xu L, Yu J, Wu Y, Geng J, Yao XD - PLoS ONE (2015)

Bottom Line: Besides, when analysis was restricted to long time regular aspirin use (>5 years), insignificant results were reported in both cohort and case-control studies.Finally, regular aspirin use might result in higher reduction of non-small cell lung cancer incidence among men.Our findings do not support the protective effect of regular aspirin use on lung cancer risk.

View Article: PubMed Central - PubMed

Affiliation: Electrocardiographic room, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

ABSTRACT

Background and purpose: Growing evidence has emerged and controversial results reported on possible relationship between aspirin use and lung cancer risk. We, therefore, conducted this updated and comprehensive meta-analysis to evaluate this issue, with focus on dose-risk and duration-risk relationships.

Methods: We searched electronic databases including PUBMED, EMBASE and Cochrane library to identify eligible studies. Relative risk (RR) and its 95% confidence interval (CI) were used for cohort studies, while odds ratio (OR) were employed for case-control studies. The random effects and fixed effects models were used for analyses.

Results: 18 studies were identified including 19835 lung cancer cases, which were eligible for inclusion in the present meta-analysis. Pooled data from case-control studies showed a significant inverse association between regular aspirin use and lung cancer risk. But for cohort studies, insignificant association was detected with little evidence of heterogeneity (RR: 1.05, 95%CI: 0.95 - 1.16; I2: 10.3%, p value: 0.351). In case-control studies, standard aspirin use (>325mg) was related to lower lung cancer incidence, compared with low-dose aspirin use (75-100mg). A similar trend was observed in cohort studies. Besides, when analysis was restricted to long time regular aspirin use (>5 years), insignificant results were reported in both cohort and case-control studies. Finally, regular aspirin use might result in higher reduction of non-small cell lung cancer incidence among men.

Conclusions: Our findings do not support the protective effect of regular aspirin use on lung cancer risk. Long time aspirin use, sex, dose and type of lung cancer might alter the effect of aspirin use on lung cancer risk. More well-designed studies are needed to further clarify these associations.

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The detailed steps of literature search in the present meta-analysis.
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pone.0122962.g001: The detailed steps of literature search in the present meta-analysis.

Mentions: The detailed flow diagram of the literature search is displayed in Fig 1. Briefly, 18 observational studies were identified involving 19835 incident cases of lung cancer, and were eligible for inclusion in the present meta-analysis. They included seven case-control studies[10, 18, 20–24]assessing 5833cases and 11210 controls, nine cohort studies[7–9, 25–30]evaluating 9262 cases among 450812 subjects, one post-trial of RCT[12]analyzing 431 cases among 39876 subjects, and a large-scale multicenter study[11] directed by ILCCO. McCormack et al.[11]pooled eight ILCCO studies that had data on aspirin or NSAID use prior to diagnosis, including one cohort-and seven case-control studies. Considering the level of evidence, the latter was assigned to the case-control group. As for gender, nine [8, 11, 12, 18, 20, 24, 27, 28, 30] of the included studies were carried out in female populations, four [9, 11, 24, 30]were in males and the remaining five dealing with both males and females. Of the 18 studies, eight [9, 12, 20, 22–24, 27, 28] referred to histology type of lung cancer and eight [12, 18, 20, 22–24, 26, 27] also assessed the effect of smoking on the relation of aspirin use and lung cancer risk (Table 1).


Aspirin use and lung cancer risk: a possible relationship? Evidence from an updated meta-analysis.

Jiang HY, Huang TB, Xu L, Yu J, Wu Y, Geng J, Yao XD - PLoS ONE (2015)

The detailed steps of literature search in the present meta-analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388842&req=5

pone.0122962.g001: The detailed steps of literature search in the present meta-analysis.
Mentions: The detailed flow diagram of the literature search is displayed in Fig 1. Briefly, 18 observational studies were identified involving 19835 incident cases of lung cancer, and were eligible for inclusion in the present meta-analysis. They included seven case-control studies[10, 18, 20–24]assessing 5833cases and 11210 controls, nine cohort studies[7–9, 25–30]evaluating 9262 cases among 450812 subjects, one post-trial of RCT[12]analyzing 431 cases among 39876 subjects, and a large-scale multicenter study[11] directed by ILCCO. McCormack et al.[11]pooled eight ILCCO studies that had data on aspirin or NSAID use prior to diagnosis, including one cohort-and seven case-control studies. Considering the level of evidence, the latter was assigned to the case-control group. As for gender, nine [8, 11, 12, 18, 20, 24, 27, 28, 30] of the included studies were carried out in female populations, four [9, 11, 24, 30]were in males and the remaining five dealing with both males and females. Of the 18 studies, eight [9, 12, 20, 22–24, 27, 28] referred to histology type of lung cancer and eight [12, 18, 20, 22–24, 26, 27] also assessed the effect of smoking on the relation of aspirin use and lung cancer risk (Table 1).

Bottom Line: Besides, when analysis was restricted to long time regular aspirin use (>5 years), insignificant results were reported in both cohort and case-control studies.Finally, regular aspirin use might result in higher reduction of non-small cell lung cancer incidence among men.Our findings do not support the protective effect of regular aspirin use on lung cancer risk.

View Article: PubMed Central - PubMed

Affiliation: Electrocardiographic room, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

ABSTRACT

Background and purpose: Growing evidence has emerged and controversial results reported on possible relationship between aspirin use and lung cancer risk. We, therefore, conducted this updated and comprehensive meta-analysis to evaluate this issue, with focus on dose-risk and duration-risk relationships.

Methods: We searched electronic databases including PUBMED, EMBASE and Cochrane library to identify eligible studies. Relative risk (RR) and its 95% confidence interval (CI) were used for cohort studies, while odds ratio (OR) were employed for case-control studies. The random effects and fixed effects models were used for analyses.

Results: 18 studies were identified including 19835 lung cancer cases, which were eligible for inclusion in the present meta-analysis. Pooled data from case-control studies showed a significant inverse association between regular aspirin use and lung cancer risk. But for cohort studies, insignificant association was detected with little evidence of heterogeneity (RR: 1.05, 95%CI: 0.95 - 1.16; I2: 10.3%, p value: 0.351). In case-control studies, standard aspirin use (>325mg) was related to lower lung cancer incidence, compared with low-dose aspirin use (75-100mg). A similar trend was observed in cohort studies. Besides, when analysis was restricted to long time regular aspirin use (>5 years), insignificant results were reported in both cohort and case-control studies. Finally, regular aspirin use might result in higher reduction of non-small cell lung cancer incidence among men.

Conclusions: Our findings do not support the protective effect of regular aspirin use on lung cancer risk. Long time aspirin use, sex, dose and type of lung cancer might alter the effect of aspirin use on lung cancer risk. More well-designed studies are needed to further clarify these associations.

Show MeSH
Related in: MedlinePlus