Skip to content

Research at St Andrews

Use of aspirin post-diagnosis in a cohort of patients with colorectal cancer and its association with all-cause and colorectal cancer specific mortality

Research output: Contribution to journalArticle


C. McCowan, A.J. Munro, P.T. Donnan, R.J.C. Steele

School/Research organisations


OBJECTIVE: Aspirin is associated with a reduced risk of developing colorectal cancer. This study examined whether patients with colorectal cancer prescribed aspirin had improved survival.

DESIGN: An observational population cohort study was undertaken using data linkage of cancer registry, dispensed prescriptions and death certificate records in Tayside, Scotland. All community prescribed aspirin pre- and post-diagnosis was extracted and periods of aspirin use post-diagnosis for each individual were analysed using Cox proportional hazard models. Main outcome measures were all-cause and colorectal mortality from death certificates.

RESULTS: Two thousand nine hundred ninety patients were identified with colorectal cancer between 1st January 1997 and 30th December 2006 and followed up until 28th February 2010. Median age at diagnosis was 73 (interquartile range [IQR] 65-80) with 52% male. One thousand nine hundred ninety-eight (67 deaths were recorded with 1021 (34 attributed to colorectal cancer. One thousand three hundred forty (45 patients used aspirin at some stage of the study period. Aspirin use post-diagnosis was associated with lower risk of all cause mortality (hazard ratio [HR]=0.67, 95% confidence interval [CI]=0.57-0.79, p60;0.001) and colorectal cancer specific mortality after allowing for age, Dukes' stage, gender, socio-economic status and aspirin use pre-diagnosis. Increasing age and stage at diagnosis were associated with increased risk, with more affluent patients at reduced risk.

CONCLUSIONS: Our study suggests that aspirin use post-diagnosis of colorectal cancer may reduce both all cause and colorectal cancer specific mortality. However further work is required to ensure this is a causal relationship and to identify whether it is best used in specific groups of patients.



Original languageUndefined/Unknown
Pages (from-to)1049-1057
Number of pages9
JournalEuropean Journal of Cancer
Issue number5
Publication statusPublished - 1 Mar 2013

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Risk factors associated with biochemically detected and hospitalised acute kidney injury in patients prescribed renin angiotensin system inhibitors

    Mark, P. B., Papworth, R., Ramparsad, N., Tomlinson, L. A., Sahwney, S., Black, C., McConnachie, A. & McCowan, C., 3 Jan 2020, In : British Journal of Clinical Pharmacology. Early View, 11 p.

    Research output: Contribution to journalArticle

  2. Why colorectal screening fails to achieve the uptake rates of breast and cervical cancer screening: a comparative qualitative study

    Kotzur, M., McCowan, C., Macdonald, S., Wyke, S., Gatting, L., Campbell, C., Weller, D., Crighton, E., Steele, R. & Robb, K., 26 Dec 2019, In : BMJ Quality & Safety. Online First

    Research output: Contribution to journalArticle

  3. Comparing uptake across breast, cervical and bowel screening at an individual level: a retrospective cohort study

    McCowan, C., McSkimming, P., Papworth, R., Kotzur, M., McConnachie, A., Macdonald, S., Wyke, S., Crighton, E., Campbell, C., Weller, D., Steele, R. JC. & Robb, K. A., 15 Oct 2019, In : British Journal of Cancer. 121, 8, p. 710–714 5 p.

    Research output: Contribution to journalArticle

  4. Healthcare disparities for women hospitalised with myocardial infarction and angina

    Jackson, A. M., Zhang, R., Robertson, K., Lindsay, M., Morris, T., Forbes, B., Papworth, R., McConnachie, A., Mangion, K., Jhund, P. S., McCowan, C. & Berry, C., 25 Jul 2019, In : European Heart Journal - Quality of Care and Clinical Outcomes.

    Research output: Contribution to journalArticle

Related by journal

  1. Perinatal complications in female survivors of cancer: a systematic review and meta-analysis

    van der Kooi, A. L., Kelsey, T. W., van den Heuvel-Eibrink, M., Laven, J. S. E., Wallace, W. H. B. & Anderson, R. A., Apr 2019, In : European Journal of Cancer. 111, p. 126-137

    Research output: Contribution to journalArticle

  2. Do participants in adjuvant breast cancer trials reflect the breast cancer patient population?

    Treweek, S., Dryden, R., McCowan, C., Harrow, A. & Thompson, A., May 2015, In : European Journal of Cancer. 51, 8, p. 907-914

    Research output: Contribution to journalArticle

  3. Regulation of exosome release from mammary epithelial and breast cancer cells - a new regulatory pathway

    Riches, A., Campbell, E., Borger, E. & Powis, S., Mar 2014, In : European Journal of Cancer. 50, 5, p. 1025-34 10 p.

    Research output: Contribution to journalArticle

  4. Pretreatment anti-Müllerian hormone predicts for loss of ovarian function after chemotherapy for early breast cancer

    Anderson, R., Rosendahl, M., Kelsey, T. & Cameron, D., Nov 2013, In : European Journal of Cancer. 49, 16, p. 3404-3411

    Research output: Contribution to journalArticle

ID: 257574486