{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:20:48Z","timestamp":1761920448030,"version":"3.37.3"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,5,16]],"date-time":"2018-05-16T00:00:00Z","timestamp":1526428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Aspirin, commonly used for prevention of cardiovascular and cerebrovascular diseases, is well known to protect against development of colorectal cancer (CRC) but increases risk of gastrointestinal bleeding (GIB). This cohort study aims to evaluate the benefit of low\u2010dose aspirin to prevent CRC and its associated risk of GIB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A population\u2010based dataset was used to compare incidence and mortality of CRC and GIB among patients receiving low\u2010dose aspirin with sex\u2010matched and age\u2010matched controls (1:2). A total of 204\u00a0170 aspirin users taking aspirin for at least 6\u00a0months and 408\u00a0339 nonusers were analyzed. Patients' clinical outcomes were documented for up to 14\u00a0years or until death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 612\u00a0509 patients were included; 5118 (2.51%) out of 204\u00a0170 aspirin users were diagnosed with CRC; and 2073 (1.02%) died of the malignancy. On the other hand, 13\u00a0336 (3.27%) out of 408\u00a0339 non\u2010aspirin users were diagnosed with CRC, and 6953 (1.70%) died. Using the competing risk regression, aspirin usage significantly reduced CRC mortality (subdistribution hazard ratio\u00a0=\u00a00.59; 95% confidence interval\u00a0=\u00a00.56 to 0.62). A total of 9483 (4.64%) aspirin users developed GIB, and 820 (0.40%) died, while 11\u00a0198 (2.74%) nonusers developed GIB, and 1488 (0.36%) died. Aspirin usage marginally increased risk of bleeding\u2010related mortality (subdistribution hazard ratio\u00a0=\u00a01.09; 95% confidence interval\u00a0=\u00a01.00 to 1.19). Subgroup analyses showed the use of acid\u2010secreting agents significantly reduced aspirin\u2010induced mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The long\u2010term use of aspirin reduces both incidence and mortality of CRC and at the same time increases incidence and mortality risk of GIB. With combination use of acid\u2010secreting agents, the bleeding risk can be reduced.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14261","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T21:49:36Z","timestamp":1524001776000},"page":"1728-1736","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Risk of gastrointestinal bleeding and benefit from colorectal cancer reduction from long\u2010term use of low\u2010dose aspirin: A retrospective study of 612\u00a0509 patients"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5580-7686","authenticated-orcid":false,"given":"Kelvin KF","family":"Tsoi","sequence":"first","affiliation":[{"name":"Stanley Ho Big Data Decision Analytics Research Centre The Chinese University of Hong Kong  Sha Tin Hong Kong"},{"name":"Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong  Sha Tin Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix CH","family":"Chan","sequence":"additional","affiliation":[{"name":"Stanley Ho Big Data Decision Analytics Research Centre The Chinese University of Hong Kong  Sha Tin Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoyee W","family":"Hirai","sequence":"additional","affiliation":[{"name":"Stanley Ho Big Data Decision Analytics Research Centre The Chinese University of Hong Kong  Sha Tin Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph JY","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Sha Tin Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,16]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-136-2-200201150-00016"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11475-1"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.296.6618.313"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60747-8"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61720-0"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61543-7"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn485"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-305827"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-3-28"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.6396"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1993.tb05689.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2011.97"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-2-201307160-00002"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-306342"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.11.007"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.05.020"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.973008"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.06.007"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199110313251801"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.12.022"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.310.6983.827"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62110-1"},{"key":"e_1_2_5_24_1","article-title":"Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement","author":"Siu AL","year":"2016","journal-title":"Ann. 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