Key result
Low-dose aspirin in VTE is linked to a ~2.8-fold higher one-year cancer risk.
Why the study?
Venous thromboembolism can be the first symptom of occult cancer, but whether it remains a marker of occult cancer among low-dose aspirin users is unknown.
Does low-dose aspirin use reduce the risk of occult cancer subsequent to a venous thromboembolism diagnosis in patients with VTE?
Cohort (n=11,759)
Does low-dose aspirin use reduce the risk of occult cancer subsequent to a venous thromboembolism diagnosis in patients with VTE?
VTE remains a strong harbinger of occult cancer during the first year after diagnosis, even among patients taking low-dose aspirin, regardless of the duration of aspirin use.
Even with low-dose aspirin, VTE signals high first-year occult cancer risk; leaves open whether aspirin mitigates this association.
Background Aspirin may reduce the risk of cancer, particularly gastrointestinal cancer, and venous thromboembolism (VTE). VTE can be the first symptom of occult cancer, but whether it is also a marker of occult cancer in aspirin users remains unknown. Therefore, we investigated the risk of cancer subsequent to VTE among users of low-dose aspirin. Methods We conducted a population-based cohort study using data from Danish health registries for the years 2001 to 2018. We identified all patients with a first-time diagnosis of VTE who also redeemed a prescription for low-dose aspirin (75–150mg) within 90 days prior to the first-time VTE. We categorized aspirin users by the number of prescriptions filled as new users (<5 prescriptions), short-term users (5–19 prescriptions), and long-term users (>19 prescriptions). We computed the absolute cancer risks and standardized incidence ratios (SIRs) for cancer using national cancer incidence rates. Results We followed-up 11,759 users of low-dose aspirin with VTE. Long-term users comprised 50% of aspirin users. The 1-year absolute risk of cancer was 6.0% for new users and 6.7% for short-term and long-term users, with corresponding SIRs of 3.3 (95% confidence interval [CI]: 2.8–4.0), 3.2 (95% CI: 2.9–3.7), and 2.8 (95% CI: 2.6–3.2), respectively. After the first year of follow-up, the SIR decreased to 1.2 (95% CI: 1.1–1.4) for new users, 1.1 (95% CI: 1.1–1.3) for short-term users, and 1.1 (95% CI: 1.0–1.2) for long-term users. Conclusion VTE may be a harbinger of cancer, even in users of low-dose aspirin, regardless of duration of use.
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Kurt et al. (2022) conducted a cohort in Venous thromboembolism (n=11,759). Low-dose aspirin vs. General population was evaluated on Any diagnosis of cancer within 1 year (long-term users) (SIR 2.8, 95% CI 2.6-3.2). Low-dose aspirin users with venous thromboembolism had a 6.0% to 6.7% absolute risk of cancer within one year, representing a 2.8- to 3.3-fold increased risk compared to the general population.
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