Aspirin use after a prostate cancer diagnosis and cancer survival in a prospective cohort
Menée sur une cohorte de 3 986 patients atteints d'un cancer de la prostate diagnostiqué entre 1990 et 2005, cette étude prospective évalue les effets de la consommation d'aspirine sur la progression de la maladie et la survie des patients
Experimental and clinical data suggest that aspirin and other non-steroidal inflammatory drugs may delay the progression of prostate cancer through inhibition of the cyclooxygenase (COX) pathway and its effects on cellular proliferation, apoptosis and angiogenesis. Epidemiological data support a reduced risk of prostate cancer incidence with aspirin use, yet no evidence exists regarding whether aspirin after diagnosis influences progression or survival. We conducted a prospective study of 3,986 participants of the Health Professionals Follow-up Study, with a prostate cancer diagnosis between January 1, 1990 and December 31, 2005. We used Cox proportional hazards regression to evaluate the association between aspirin use after diagnosis and the development of metastases or fatal prostate cancer through January 31, 2008, adjusting for risk factors associated with incidence and mortality in this cohort, pre-diagnostic aspirin use, Gleason score, TNM stage and primary treatment. In total, 265 men developed bony or other organ metastases or fatal prostate cancer during the 18 years of follow-up. We observed no association between updated aspirin use after diagnosis and lethal prostate cancer (tablets/week: <2, HR=1.12, 95% CI: 0.72, 1.72; 2-5, HR=1.05, 95% CI: 0.62, 1.80, > 6, HR=1.08, 95% CI: 0.76, 1.54; p-trend=0.99). The results remained unchanged when we examined aspirin use at baseline only (p-trend=0.70) or frequency of use (days/week, p-trend=0.35); or limited the outcome to fatal prostate cancer (p-trend = 0.63). There was no association between aspirin use after a prostate cancer diagnosis and lethal disease in this cohort of prostate cancer survivors.