Aspirin has been associated to a reduced risk of colorectal and possibly of a few other common cancers.
To provide an up-to-date quantification of this association, we conducted a meta-analysis of ...all observational studies on aspirin and 12 selected cancer sites published up to September 2011.
Regular aspirin is associated with a statistically significant reduced risk of colorectal cancer summary relative risk (RR) from random effects models = 0.73, 95% confidence interval (CI) 0.67–0.79, and of other digestive tract cancers (RR = 0.61, 95% CI = 0.50–0.76, for squamous cell esophageal cancer; RR = 0.64, 95% CI = 0.52–0.78, for esophageal and gastric cardia adenocarcinoma; and RR = 0.67, 95% CI = 0.54–0.83, for gastric cancer), with somewhat stronger reductions in risk in case–control than in cohort studies. Modest inverse associations were also observed for breast (RR = 0.90, 95% CI = 0.85–0.95) and prostate cancer (RR = 0.90, 95% CI = 0.85–0.96), while lung cancer was significantly reduced in case–control studies (0.73, 95% CI = 0.55–0.98) but not in cohort ones (RR = 0.98, 95% CI = 0.92–1.05). No meaningful overall associations were observed for cancers of the pancreas, endometrium, ovary, bladder, and kidney.
Observational studies indicate a beneficial role of aspirin on colorectal and other digestive tract cancers; modest risk reductions were also observed for breast and prostate cancer. Results are, however, heterogeneous across studies and dose–risk and duration–risk relationships are still unclear.
From most recent available data, we projected cancer mortality statistics for 2014, for the European Union (EU) and its six more populous countries. Specific attention was given to pancreatic cancer, ...the only major neoplasm showing unfavorable trends in both sexes.
Population and death certification data from stomach, colorectum, pancreas, lung, breast, uterus, prostate, leukemias and total cancers were obtained from the World Health Organisation database and Eurostat. Figures were derived for the EU, France, Germany, Italy, Poland, Spain and the UK. Projected 2014 numbers of deaths by age group were obtained by linear regression on estimated numbers of deaths over the most recent time period identified by a joinpoint regression model.
In the EU in 2014, 1 323 600 deaths from cancer are predicted (742 500 men and 581 100 women), corresponding to standardized death rates of 138.1/100 000 men and 84.7/100 000 women, falling by 7% and 5%, respectively, since 2009. In men, predicted rates for the three major cancers (lung, colorectum and prostate cancer) are lower than in 2009, falling by 8%, 4% and 10%, respectively. In women, breast and colorectal cancers had favorable trends (-9% and -7%), but female lung cancer rates are predicted to rise 8%. Pancreatic cancer is the only neoplasm with a negative outlook in both sexes. Only in the young (25–49 years), EU trends become more favorable in men, while women keep registering slight predicted rises.
Cancer mortality predictions for 2014 confirm the overall favorable cancer mortality trend in the EU, translating to an overall 26% fall in men since its peak in 1988, and 20% in women, and the avoidance of over 250 000 deaths in 2014 compared with the peak rate. Notable exceptions are female lung cancer and pancreatic cancer in both sexes.
Aspirin has been associated with a reduced risk of colorectal cancer, and possibly of a few other digestive tract cancers. The quantification of risk reduction and the optimal dose and duration of ...aspirin use for the prevention of colorectal and other digestive tract cancers remains unclear.
To provide an up-to-date quantification of this association, we conducted a systematic review and meta-analysis of all observational studies on aspirin and cancers of the digestive tract sites published through March 2019. We estimated the pooled relative risk (RR) of cancer for regular aspirin use versus non-use using random-effects models, and, whenever data were available, we investigated the dose- and duration-risk relations.
Regular aspirin use is associated with a reduced risk of colorectal cancer RR = 0.73, 95% confidence interval (CI) = 0.69–0.78, 45 studies, squamous-cell esophageal cancer (RR = 0.67, 95% CI = 0.57–0.79, 13 studies), adenocarcinoma of the esophagus and gastric cardia (RR = 0.61, 95% CI = 0.49–0.77, 10 studies), stomach cancer (RR = 0.64, 95% CI = 0.51–0.82, 14 studies), hepato-biliary tract cancer (RR = 0.62, 95% CI = 0.44–0.86, five studies), and pancreatic cancer (RR = 0.78, 95% CI = 0.68–0.89, 15 studies), but not of head and neck cancer (RR = 0.94, 95% CI = 0.76–1.16, 10 studies). The associations are somewhat stronger in case-control than in cohort and nested case-control studies and are characterized by some between-study heterogeneity. Risk estimates are consistent across sex, geographical areas, and other selected covariates. For colorectal cancer, an aspirin dose between 75 and 100 mg/day conveys a risk reduction of 10%, and a dose of 325 mg/day of 35%. For all neoplasms, except head and neck cancer, inverse duration-risk relations with aspirin use are found.
The present comprehensive meta-analysis supports and further quantifies the inverse association between regular aspirin use and the risk of colorectal and other digestive tract cancers, including some rare ones. The favorable effect of aspirin increases with longer duration of use, and, for colorectal cancer, with increasing dose.
•Forty-five studies on over 150 000 colorectal cancers indicate that aspirin use is associated with a greater than 25% risk reduction.•Colorectal cancer risk is inversely related to the dose and duration of aspirin use.•Aspirin use is also inversely related to esophageal, stomach, liver, and pancreatic cancer.
Alcohol is a risk factor for cancer of the oral cavity, pharynx, oesophagus, colorectum, liver, larynx and female breast, whereas its impact on other cancers remains controversial.
We investigated ...the effect of alcohol on 23 cancer types through a meta-analytic approach. We used dose-response meta-regression models and investigated potential sources of heterogeneity.
A total of 572 studies, including 486 538 cancer cases, were identified. Relative risks (RRs) for heavy drinkers compared with nondrinkers and occasional drinkers were 5.13 for oral and pharyngeal cancer, 4.95 for oesophageal squamous cell carcinoma, 1.44 for colorectal, 2.65 for laryngeal and 1.61 for breast cancer; for those neoplasms there was a clear dose-risk relationship. Heavy drinkers also had a significantly higher risk of cancer of the stomach (RR 1.21), liver (2.07), gallbladder (2.64), pancreas (1.19) and lung (1.15). There was indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer. Alcohol consumption and risk of Hodgkin's and Non-Hodgkin's lymphomas were inversely associated.
Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.
A decrease in cancer mortality has been reported in the United States, Europe, and other high-income regions during the last two decades. Whether similar trends apply to low-to-middle income ...countries—and globally—is unclear.
The aim of this descriptive study is to compare cancer mortality in all countries with high- or intermediate-quality data on death certificates according to the World Health Organization (WHO) mortality database for the years 2000 through 2010. We included 60 countries in the analysis and calculated age-adjusted mortality rates for all cancer combined and for the commonest cancers worldwide: lung, stomach, breast, colorectal, uterine, and prostate.
A decrease in overall cancer mortality rate of ∼1% per year was observed in higher and lower income regions and in both sexes. In 2010, 696 000 cancer deaths were avoided on a global scale compared with 2000 rates (426 000 in men, 271 000 in women). However, the mortality of liver cancer in both sexes and lung cancer in females increased in many countries'.
The individual risk of dying from cancer decreased in all countries with reliable data. This decrease was chiefly due to favorable trends in the commonest specific cancers. Liver cancer in both sexes and lung cancer in women, which show increasing mortality rates, constitute a priority for prevention and further research.
Estimated cancer mortality statistics were published for the years 2011 and 2012 for the European Union (EU) and its six more populous countries.
Using logarithmic Poisson count data joinpoint models ...and the World Health Organization mortality and population database, we estimated numbers of deaths and age-standardized (world) mortality rates (ASRs) in 2013 from all cancers and selected cancers.
The 2013 predicted number of cancer deaths in the EU is 1 314 296 (737 747 men and 576 489 women). Between 2009 and 2013, all cancer ASRs are predicted to fall by 6% to 140.1/100 000 in men, and by 4% to 85.3/100 000 in women. The ASRs per 100 000 are 6.6 men and 2.9 women for stomach, 16.7 men and 9.5 women for intestines, 8.0 men and 5.5 women for pancreas, 37.1 men and 13.9 women for lung, 10.5 men for prostate, 14.6 women for breast, and 4.7 for uterine cancer, and 4.2 and 2.6 for leukaemia. Recent trends are favourable except for pancreatic cancer and lung cancer in women.
Favourable trends will continue in 2013. Pancreatic cancer has become the fourth cause of cancer death in both sexes, while in a few years lung cancer will likely become the first cause of cancer mortality in women as well, overtaking breast cancer.
We projected cancer mortality statistics for 2018 for the European Union (EU) and its six more populous countries, using the most recent available data. We focused on colorectal cancer.
We obtained ...cancer death certification data from stomach, colorectum, pancreas, lung, breast, uterus, ovary, prostate, bladder, leukaemia, and total cancers from the World Health Organisation database and projected population data from Eurostat. We derived figures for France, Germany, Italy, Poland, Spain, the UK, and the EU in 1970–2012. We predicted death numbers by age group and age-standardized (world population) rates for 2018 through joinpoint regression models.
EU total cancer mortality rates are predicted to decline by 10.3% in men between 2012 and 2018, reaching a predicted rate of 128.9/100000, and by 5.0% in women with a rate of 83.6. The predicted total number of cancer deaths is 1382000 when compared with 1333362 in 2012 (+3.6%). We confirmed a further fall in male lung cancer, but an unfavourable trend in females, with a rate of 14.7/100000 for 2018 (13.9 in 2012,+5.8%) and 94500 expected deaths, higher than the rate of 13.7 and 92700 deaths from breast cancer. Colorectal cancer predicted rates are 15.8/100000 men (−6.7%) and 9.2 in women (−7.5%); declines are expected in all age groups. Pancreatic cancer is stable in men, but in women it rose+2.8% since 2012. Ovarian, uterine and bladder cancer rates are predicted to decline further. In 2018 alone, about 392300 cancer deaths were avoided compared with peak rates in the late 1980s.
We predicted continuing falls in mortality rates from major cancer sites in the EU and its major countries to 2018. Exceptions are pancreatic cancer and lung cancer in women. Improved treatment and—above age 50years—organized screening may account for recent favourable colorectal cancer trends.
The incidence rates of esophageal and gastric cardia adenocarcinoma (EGCA) have increased over recent years in several countries, and overweight/obesity has been suggested to play a major role in ...these trends. In fact, higher body mass index (BMI) has been positively associated with EGCA in several studies.
We conducted a meta-analysis of case–control and cohort studies on the BMI and EGCA updated to March 2011. We estimated overall relative risks (RRs) and 95% confidence intervals (CI) for BMI between 25 and 30 and BMI ≥ 30 kg/m2, when compared with normo-weight subjects, using random-effects models.
We identified 22 studies, including almost 8000 EGCA cases. The overall RR was 1.71 (95% CI 1.50–1.96) for BMI between 25 and 30, and was 2.34 (95% CI 1.95–2.81) for BMI ≥ 30 kg/m2. The continuous RR for an increment of 5 kg/m2 of BMI was 1.11 (95% CI 1.09–1.14). The association was stronger for esophageal adenocarcinoma (RR for BMI ≥ 30 kg/m2 = 2.73, 95% CI 2.16–3.46) than for gastric cardia adenocarcinoma (RR for BMI ≥ 30 kg/m2 = 1.93, 95% CI 1.52–2.45). No substantial differences emerged across strata of sex and geographic areas.
Overweight and obesity are strongly related to EGCA, particularly to espophageal adenocarcinoma.
Total cancer mortality rates in the EU are predicted to fall 7.5% in men and 6% in women between 2009 and 2015. However, due to population aging, total number of cancer deaths will rise to 1 359 100. ...Cancer mortality outlook for 2015 remains favourable, except for pancreas in both sexes and female lung that is predicted to overtake breast becoming the female cancer with the highest rate (14.24/100 000).
Cancer mortality statistics for 2015 were projected from the most recent available data for the European Union (EU) and its six more populous countries. Prostate cancer was analysed in detail.
Population and death certification data from stomach, colorectum, pancreas, lung, breast, uterus, prostate, leukaemias and total cancers were obtained from the World Health Organisation database and Eurostat. Figures were derived for the EU, France, Germany, Italy, Poland, Spain and the UK. Projected 2015 numbers of deaths by age group were obtained by linear regression on estimated numbers of deaths over the most recent time period identified by a joinpoint regression model.
A total of 1 359 100 cancer deaths are predicted in the EU in 2015 (766 200 men and 592 900 women), corresponding to standardised death rates of 138.4/100 000 men and 83.9/100 000 women, falling 7.5% and 6%, respectively, since 2009. In men, predicted rates for the three major cancers (lung, colorectum and prostate) are lower than in 2009, falling 9%, 5% and 12%. Prostate cancer showed predicted falls of 14%, 17% and 9% in the 35–64, 65–74 and 75+ age groups. In women, breast and colorectal cancers had favourable trends (-10% and -8%), but predicted lung cancer rates rise 9% to 14.24/100 000 becoming the cancer with the highest rate, reaching and possibly overtaking breast cancer rates—though the total number of deaths remain higher for breast (90 800) than lung (87 500). Pancreatic cancer has a negative outlook in both sexes, rising 4% in men and 5% in women between 2009 and 2015.
Cancer mortality predictions for 2015 confirm the overall favourable cancer mortality trend in the EU, translating to an overall 26% fall in men since its peak in 1988, and 21% in women, and the avoidance of over 325 000 deaths in 2015 compared with the peak rate.
To overcome the lag with which cancer statistics become available, we predicted numbers of deaths and rates from all cancers and selected cancer sites for 2019 in the European Union (EU).
We ...retrieved cancer death certifications and population data from the World Health Organization and Eurostat databases for 1970–2014. We obtained estimates for 2019 with a linear regression on number of deaths over the most recent trend period identified by a logarithmic Poisson joinpoint regression model. We calculated the number of avoided deaths over the period 1989–2019.
We estimated about 1 410 000 cancer deaths in the EU for 2019, corresponding to age-standardized rates of 130.9/100 000 men (−5.9% since 2014) and 82.9 women (−3.6%). Lung cancer trends in women are predicted to increase 4.4% between 2014 and 2019, reaching a rate of 14.8. The projected rate for breast cancer was 13.4. Favourable trends for major neoplasms are predicted to continue, except for pancreatic cancer. Trends in breast cancer mortality were favourable in all six countries considered, except Poland. The falls were largest in women 50–69 (−16.4%), i.e. the age group covered by screening, but also seen at age 20–49 (−13.8%), while more modest at age 70–79 (−6.1%). As compared to the peak rate in 1988, over 5 million cancer deaths have been avoided in the EU over the 1989–2019 period. Of these, 440 000 were breast cancer deaths.
Between 2014 and 2019, cancer mortality will continue to fall in both sexes. Breast cancer rates will fall steadily, with about 35% decline in rates over the last three decades. This is likely due to reduced hormone replacement therapy use, improvements in screening, early diagnosis and treatment. Due to population ageing, however, the number of breast cancer deaths is not declining.
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