4.6 Article

NSAID use and unnatural deaths after cancer diagnosis: a nationwide cohort study in Sweden

期刊

BMC CANCER
卷 22, 期 1, 页码 -

出版社

BMC
DOI: 10.1186/s12885-021-09120-9

关键词

Accident; Aspirin; cancer; NSAIDs; Suicide; Cohort study

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资金

  1. Karolinska Institute
  2. Swedish Cancer Society [CAN 2014/417, 20 0846 PjF]
  3. Swedish Research Council for Health, Working Life and Welfare [2017-00531]
  4. Karolinska Institutet Senior Researcher Award
  5. Strategic Research Area in Epidemiology Award
  6. China Scholarship Council [201407930016]
  7. National Health and Medical Research Council [GNT1147498]
  8. National Breast Cancer Foundation [IIRS-20-025]
  9. National Breast Cancer Foundation [IIRS-20-025] Funding Source: researchfish

向作者/读者索取更多资源

Intake of low-dose aspirin after cancer diagnosis was associated with a lower risk of unnatural deaths among cancer patients.
Background Cancer patients experience increased risk of death from accident and suicide. Cognitive impairment induced by cancer-related inflammation and stress-related psychiatric symptoms may be underlying mechanisms. We therefore studied the association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and risk of these outcomes. Methods Following a cohort of 388,443 cancer patients diagnosed between October 2005 and December 2014 in Sweden, we ascertained dispense of aspirin or non-aspirin NSAIDs from 3 months before cancer diagnosis onward and defined the on-medication period as from date of drug dispense until the prescribed dosage was consumed. Follow-up time outside medicated periods and time from unexposed patients were defined as off-medication periods. We used Cox models to estimate hazard ratios (HRs) of death due to suicide or accident, by comparing the on-medication periods with off-medication periods. Results In total, 29.7% of the cancer patients had low-dose aspirin dispensed and 29.1% had non-aspirin NSAIDs dispensed. Patients with aspirin use were more likely to be male than patients without aspirin use. Compared with off-medication periods, there was a 22% lower risk of accidental death (N = 651; HR 0.78, 95% confidence interval [CI]: 0.70 to 0.87) during on-medication periods with aspirin. The use of aspirin was not associated with risk of suicide (N = 59; HR 0.96, 95% CI: 0.66 to 1.39). No association was noted between use of non-aspirin NSAIDs and the risk of suicide (N = 13; HR 0.95, 95% CI: 0.42 to 2.18) or accidental death (N = 59; HR 0.92, 95% CI: 0.68 to 1.26). Conclusions Intake of low-dose aspirin after cancer diagnosis was associated with a lower risk of unnatural deaths among cancer patients.

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