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Comment & Response
October 2016

Aspirin and Cancer Risk

Author Affiliations
  • 1Ohio State University–James Comprehensive Cancer Center, Columbus
  • 2Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, Washington
  • 3School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
JAMA Oncol. 2016;2(10):1370. doi:10.1001/jamaoncol.2016.2305

To the Editor We read with interest the recent article by Cao et al,1 which examined the association between long-term aspirin use and cancer risk. The authors imply that besides the Cancer Prevention Study II, no prior studies have examined these associations. Indeed, the finding of Cao et al1 of inverse associations for total cancer risk restricted to men echoes findings from several prior observational studies24 and a randomized trial.5 In 2007, data from the Iowa Women’s Health Study suggested some benefit of aspirin use for total cancer risk.2 However, in the Vitamins and Lifestyle cohort, we found that long-term use of adult-strength aspirin was inversely associated with total cancer incidence among men (HR, 0.89; 95% CI, 0.80-0.99) but not women (P for interaction = .01).3 We also examined associations of aspirin use with risk of individual cancers. This analysis is the only one to examine interaction by sex for shared cancer sites aside from the colorectum. Different from Cao et al,1 we reported reductions in risk of these cancers for men (HR, 0.84; 95% CI, 0.71-0.99) but not women (HR, 1.18; 95% CI, 0.93-1.49; P for interaction < .01).3 The results of this analysis suggested that aside from associations with reduced colorectal cancer incidence, which were apparent in both sexes, use of aspirin for cancer prevention at other cancer sites shared between the sexes conferred little benefit to women.3

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