ArticlePloS one2016
The Protective Effect of Low-Dose Aspirin against Colorectal Cancer Is Unlikely Explained by Selection Bias: Results from Three Different Study Designs in Clinical Practice.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Associations between aspirin use and the risk of cancers: a meta-analysis of observational studies.BMC cancer · 2018Pooled it
- Metformin therapy and the risk of colorectal adenoma in patients with type 2 diabetes: A meta-analysis.Oncotarget · 2017 · on this mapPooled it
- Platelet P2Y12 inhibitor use and risk of colorectal cancer incidence and colorectal cancer-related mortality: a Swedish registry-based cohort study.BMC gastroenterology · 2026Article
- Risk Factors and Prevention of Cancer and CVDs: A Chicken and Egg Situation.Journal of clinical medicine · 2025Review
- Article
- Aspirin for prevention of colorectal cancer in the elderly: friend or foe?Annals of gastroenterology · 2021Review
- Low-dose aspirin and risk of gastric and oesophageal cancer: A population-based study in the United Kingdom using The Health Improvement Network.International journal of cancer · 2020Article
- Metabolic dysfunction and early-onset colorectal cancer - how macrophages build the bridge.Cancer medicine · 2020Review
- Reviewing the role of P2Y receptors in specific gastrointestinal cancers.Purinergic signalling · 2019Article
- Antiplatelet Agents for Cancer Prevention: Current Evidences and Continuing Controversies.Cancers · 2019Review
- Effects of Aspirin or Clopidogrel on Colorectal Cancer Chemoprevention in Patients with Type 2 Diabetes Mellitus.Cancers · 2019Article
- Conditions Associated with Essential Tremor in Veterans: A Potential Role for Chronic Stress.Tremor and other hyperkinetic movements (New York, N.Y.) · 2018Article
- New use of low-dose aspirin and risk of colorectal cancer by stage at diagnosis: a nested case-control study in UK general practice.BMC cancer · 2017Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe conducted three differently designed nested case-control studies to evaluate whether the protective effect of low-dose aspirin against colorectal cancer (CRC) is explained by selection bias.
methodsUsing a large validated UK primary care database, we followed different cohorts of patients, who varied in their demographic and clinical characteristics, to identify first ever cases of CRC. In Studies 1 and 2, two cohorts were followed, i) new users of low-dose aspirin at start of follow-up (N = 170,336 in Study 1, N = 171,527 in Study 2) and either ii) non-users of low-dose aspirin (Study 1, N = 170,336) or new users of paracetamol (Study 2, N = 149,597) at start of follow-up. In Study 3 a single cohort of individuals näive to low-dose aspirin at the start of observation was followed. Controls were selected using incidence sampling and logistic regression used to obtain an unbiased estimate of the incidence rate ratio (RR) with 95% confidence intervals (CIs). Low-dose aspirin exposure was analyzed 'as-treated' before the index date (CRC date for cases, random date for controls).
resultsIn the three studies, median (maximum) follow-up was 5.1 (12), 5.8 (12) and 7.5 (13) years, respectively. 3033 incident CRC cases were identified in Study 1, 3174 in Study 2, and 12,333 in Study 3. Current use of low-dose aspirin was associated with a significantly reduced risk of 34%, 29% and 31% in the three studies, respectively; corresponding RRs (95% CIs) were 0.66 (0.60-0.73), 0.71 (0.63-0.80) and 0.69 (0.64-0.74). In each study, significantly reduced risks of CRC were seen when low-dose aspirin was used for primary or secondary cardiovascular disease prevention, in both sexes, and across all age groups evaluated.
conclusionLow-dose aspirin is associated with a significantly reduced risk of CRC. The consistency of our findings across different studies makes selection bias an unlikely explanation.
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