{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:49:56Z","timestamp":1782877796095,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Previous studies suggest that the use of low\u2010dose aspirin before a colorectal cancer (CRC) diagnosis may be associated with a decreased risk of CRC progression. Data supporting this association, however, have been inconsistent. We evaluate whether the use of prediagnostic low\u2010dose aspirin is associated with a lower risk of metastases and all\u2010cause mortality in CRC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a large Italian population\u2010based primary care database, we identified a cohort of 7478 patients newly diagnosed with nonmetastatic CRC between 2000 and 2013. Use of prediagnostic low\u2010dose aspirin was compared with no use of low\u2010dose aspirin. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of incident metastasis and of all\u2010cause mortality associated with prediagnostic low\u2010dose aspirin use, both overall and by duration of use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 314 incident metastatic events and 2189 deaths during a mean follow\u2010up time of 4.4 and 4.7 years, respectively. Overall prediagnostic use of low\u2010dose aspirin was not associated with a decreased risk of incident metastasis (HR 0.88; 95% CI 0.63\u20131.22) or all\u2010cause mortality (HR 1.09; 95% CI 0.96\u20131.22) in CRC patients. Cumulative duration of aspirin use was not associated with a decreased risk of incident metastasis (<jats:italic>P<\/jats:italic>\u2010trend = .22) or all\u2010cause mortality (<jats:italic>P<\/jats:italic>\u2010trend = .38). These findings remained consistent in sensitivity analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this real\u2010world, population\u2010based study, the prediagnostic use of low\u2010dose aspirin was not associated with a decreased risk of incident metastasis or all\u2010cause mortality in CRC patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.14329","type":"journal-article","created":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T19:26:53Z","timestamp":1588274813000},"page":"2266-2273","source":"Crossref","is-referenced-by-count":4,"title":["Prediagnostic use of low\u2010dose aspirin and risk of incident metastasis and all\u2010cause mortality among patients with colorectal cancer"],"prefix":"10.1111","volume":"86","author":[{"given":"Giovanni","family":"Giorli","sequence":"first","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute  Jewish General Hospital Montreal Canada"},{"name":"Department of Epidemiology, Biostatistics, and Occupational Health McGill University  Montreal Canada"},{"name":"Department of Statistics and Quantitative Methods, Unit of Biostatistics and Epidemiology University of Milano\u2010Bicocca  Milan Italy"},{"name":"Experimental Medicine and Rheumatology, William Harvey Research Institute Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Rouette","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute  Jewish General Hospital Montreal Canada"},{"name":"Department of Epidemiology, Biostatistics, and Occupational Health McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Yin","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute  Jewish General Hospital Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lapi","sequence":"additional","affiliation":[{"name":"Health Search Italian College of General Practitioners and Primary Care \u2013 SIMG  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Health Search Italian College of General Practitioners and Primary Care \u2013 SIMG  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Cricelli","sequence":"additional","affiliation":[{"name":"Health Search Italian College of General Practitioners and Primary Care \u2013 SIMG  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pollak","sequence":"additional","affiliation":[{"name":"Segal Cancer Center Lady Davis Institute for Medical Research  Jewish General Hospital Montreal Canada"},{"name":"Gerald Bronfman Department of Oncology McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5162-3556","authenticated-orcid":false,"given":"Laurent","family":"Azoulay","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute  Jewish General Hospital Montreal Canada"},{"name":"Department of Epidemiology, Biostatistics, and Occupational Health McGill University  Montreal Canada"},{"name":"Gerald Bronfman Department of Oncology McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-0577"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.221143"},{"key":"e_1_2_11_5_1","first-page":"5662","article-title":"Nonsteroidal anti\u2010inflammatory drugs: effects on mortality after colorectal cancer diagnosis","volume":"115","author":"Zell JA","year":"2009","journal-title":"Cancer Interdiscip Int J am Cancer 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