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Association of Aspirin, Metformin, and Statin Use with Gastric Cancer Incidence and Mortality: A Nationwide Cohort Study
- Source :
- Cancer prevention research (Philadelphia, Pa.). 14(1)
- Publication Year :
- 2020
-
Abstract
- Anticancer effects of aspirin, metformin, and statins against gastric cancer, one of the most common cancers in the world, have been reported. This retrospective cohort study aimed to investigate independent associations of aspirin, metformin, and statin use with gastric cancer incidence and mortality after adjustment for concomitant use of other drugs, using pooled cohort data extracted from the Korean National Health Insurance claim database. Follow-up started on January 1, 2004 and ended at the date of gastric cancer diagnosis, death, or December 31, 2013. Exposures to drugs were defined as cumulative duration of use for aspirin and cumulative defined daily dose for metformin and statin, and were entered as time-dependent variables in Cox analysis models to avoid immortal time bias. Use of aspirin for longer than 182.5 and 547.5 days during 2-year interval was associated with reduced risks of gastric cancer incidence and mortality, respectively. Patients with diabetes were at higher risk of gastric cancer incidence and mortality than nondiabetic people, regardless of metformin treatment. However, metformin use among patients with diabetes was associated with a reduction in gastric cancer mortality in a dose-response manner. Statin use was also associated with a reduction of gastric cancer mortality in the general population, but not with gastric cancer incidence. In conclusion, long-term use of aspirin was independently associated with reduced incidence and mortality of gastric cancer in the general population, but metformin or statin use was only associated with a reduction of gastric cancer mortality in patients with diabetes and in the general population, respectively. Prevention Relevance: Long-term use of aspirin was independently associated with reduced incidence and mortality of gastric cancer in the general population. Metformin or statin use, however, was only associated with a reduction of gastric cancer mortality in diabetic patients and in the general population in a dose-response manner, respectively.
- Subjects :
- 0301 basic medicine
Adult
Male
Cancer Research
medicine.medical_specialty
Statin
medicine.drug_class
Population
03 medical and health sciences
0302 clinical medicine
Stomach Neoplasms
Internal medicine
Republic of Korea
Medicine
Humans
Mortality
education
Aged
Retrospective Studies
Aspirin
education.field_of_study
business.industry
Incidence (epidemiology)
Incidence
digestive, oral, and skin physiology
nutritional and metabolic diseases
Cancer
Retrospective cohort study
Middle Aged
medicine.disease
Metformin
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Cohort
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
medicine.drug
Subjects
Details
- ISSN :
- 19406215
- Volume :
- 14
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Cancer prevention research (Philadelphia, Pa.)
- Accession number :
- edsair.doi.dedup.....18b27a7c638d0973095c4400f0cd6698