TY - JOUR
T1 - Association of Daily Aspirin Therapy With Hepatocellular Carcinoma Risk in Patients With Chronic Hepatitis C Virus Infection
AU - Lee, Teng Yu
AU - Hsu, Yao Chun
AU - Tseng, Hsiao Ching
AU - Lin, Jaw Town
AU - Wu, Ming Shiang
AU - Wu, Chun Ying
N1 - Publisher Copyright:
© 2020 AGA Institute
PY - 2020/11
Y1 - 2020/11
N2 - Background & Aims: Aspirin therapy has been associated with reduced risk of colon cancer, but there is only limited evidence for its effects on risk of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. Methods: In this cohort study, based on Taiwan's National Health Insurance Research Database, we screened 237,963 patients with chronic HCV infection for the period of 1997 through 2011. We excluded patients with confounding conditions and 2478 patients who continuously received daily aspirin therapy for 90 days or more (treated group) were randomly matched 1:2 with 4956 patients who had never received antiplatelet therapy (untreated group) by means of propensity scores. Cumulative incidence of, and hazard ratio (HR) for, HCC development were analyzed after we adjusted for patient mortality as a competing risk event. Results: The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group over 5 years (4.67%; 95% CI, 3.74%–5.59% vs 7.32%; 95% CI, 6.33%–8.30%; P<.001). In the multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR, 0.78, 95% CI, 0.64–0.95; P = .011), after adjustment for age per year, male sex, cirrhosis, liver decompensation, hyperlipidemia, statin use, and interferon therapy. Sensitivity subgroup analyses also verified this association (all HRs<1.0). In addition, older age (HR, 1.03 per year; 95% CI, 1.02–1.04), male sex (HR, 1.46; 95% CI, 1.21–1.77), and cirrhosis (HR, 3.13; 95% CI, 2.55–3.84) were independently associated with an increased HCC risk. Conclusions: In a nationwide cohort study in Taiwan, we found aspirin therapy to be significantly associated with a reduced risk of HCV-related HCC.
AB - Background & Aims: Aspirin therapy has been associated with reduced risk of colon cancer, but there is only limited evidence for its effects on risk of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). We aimed to investigate the association of daily aspirin therapy with HCV-related HCC risk. Methods: In this cohort study, based on Taiwan's National Health Insurance Research Database, we screened 237,963 patients with chronic HCV infection for the period of 1997 through 2011. We excluded patients with confounding conditions and 2478 patients who continuously received daily aspirin therapy for 90 days or more (treated group) were randomly matched 1:2 with 4956 patients who had never received antiplatelet therapy (untreated group) by means of propensity scores. Cumulative incidence of, and hazard ratio (HR) for, HCC development were analyzed after we adjusted for patient mortality as a competing risk event. Results: The cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group over 5 years (4.67%; 95% CI, 3.74%–5.59% vs 7.32%; 95% CI, 6.33%–8.30%; P<.001). In the multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR, 0.78, 95% CI, 0.64–0.95; P = .011), after adjustment for age per year, male sex, cirrhosis, liver decompensation, hyperlipidemia, statin use, and interferon therapy. Sensitivity subgroup analyses also verified this association (all HRs<1.0). In addition, older age (HR, 1.03 per year; 95% CI, 1.02–1.04), male sex (HR, 1.46; 95% CI, 1.21–1.77), and cirrhosis (HR, 3.13; 95% CI, 2.55–3.84) were independently associated with an increased HCC risk. Conclusions: In a nationwide cohort study in Taiwan, we found aspirin therapy to be significantly associated with a reduced risk of HCV-related HCC.
KW - Asia
KW - Inflammation
KW - Liver Cancer
KW - Population
UR - http://www.scopus.com/inward/record.url?scp=85092925537&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2020.04.036
DO - 10.1016/j.cgh.2020.04.036
M3 - Article
C2 - 32360983
AN - SCOPUS:85092925537
SN - 1542-3565
VL - 18
SP - 2784-2792.e7
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 12
ER -