Investigating aspirin and post-colonoscopy colorectal cancer and cancer-specific mortality risk: a Swedish Register Study 2007-2016.
[OBJECTIVE] Acetylsalicylic acid (ASA) has been linked to reduced incidence and mortality in colorectal cancer (CRC), although its sex-specific effects remain unclear.
- p-value P = 0.043
- p-value P = 0.040
- 95% CI 0.93-1.37
- HR 1.13
APA
Forsberg A, Widman L, Andreasson A (2026). Investigating aspirin and post-colonoscopy colorectal cancer and cancer-specific mortality risk: a Swedish Register Study 2007-2016.. European journal of gastroenterology & hepatology. https://doi.org/10.1097/MEG.0000000000003177
MLA
Forsberg A, et al.. "Investigating aspirin and post-colonoscopy colorectal cancer and cancer-specific mortality risk: a Swedish Register Study 2007-2016.." European journal of gastroenterology & hepatology, 2026.
PMID
41870898
Abstract
[OBJECTIVE] Acetylsalicylic acid (ASA) has been linked to reduced incidence and mortality in colorectal cancer (CRC), although its sex-specific effects remain unclear. Post-colonoscopy colorectal cancer (PCCRC), is a CRC diagnosed after a colonoscopy negative for cancer. The aim of this study was to explore the sex-specific effects of ASA on cancer-specific mortality risk in in CRC in general and in PCCRC specifically.
[METHODS] This retrospective register-based study analyzed the conditional CRC-specific survival in 22 270 Swedish patients who underwent colonoscopy, including 1647 PCCRCs. The analyses were stratified on sex.
[RESULTS] ASA use was associated with lower CRC mortality in men but not in women, hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.72-0.99, P = 0.043 for men and HR = 1.13, 95% CI: 0.93-1.37, P = 0.230 for women. Notably, ASA use in women, but not in men, with PCCRC was linked to increased mortality risk; HR for interaction PCCRC × ASA in women = 1.60, 95% CI: 1.02-2.51, P = 0.040 and HR for interaction PCCRC × ASA in men = 0.81, 95% CI: 0.50-1.32, P = 0.41.
[CONCLUSION] These exploratory analyses suggest sex-specific differences in the effect of ASA on CRC outcomes, particularly in PCCRC. Further research is needed to elucidate underlying the mechanisms and optimize chemopreventive strategies.
[METHODS] This retrospective register-based study analyzed the conditional CRC-specific survival in 22 270 Swedish patients who underwent colonoscopy, including 1647 PCCRCs. The analyses were stratified on sex.
[RESULTS] ASA use was associated with lower CRC mortality in men but not in women, hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.72-0.99, P = 0.043 for men and HR = 1.13, 95% CI: 0.93-1.37, P = 0.230 for women. Notably, ASA use in women, but not in men, with PCCRC was linked to increased mortality risk; HR for interaction PCCRC × ASA in women = 1.60, 95% CI: 1.02-2.51, P = 0.040 and HR for interaction PCCRC × ASA in men = 0.81, 95% CI: 0.50-1.32, P = 0.41.
[CONCLUSION] These exploratory analyses suggest sex-specific differences in the effect of ASA on CRC outcomes, particularly in PCCRC. Further research is needed to elucidate underlying the mechanisms and optimize chemopreventive strategies.