Association of aspirin, metformin, and statin use with gastric cancer incidence and mortality: A nationwide cohort study

Menée à l'aide de données 2004-2013 de l'assurance maladie coréenne portant sur plus d'1,7 million de personnes, cette étude analyse l'association entre l'utilisation d'aspirine, de metformine ou de statines et l'incidence du cancer gastrique (26 093 cas) ainsi que la mortalité associée (12 456 décès)

Résumé en anglais

Anticancer effects of aspirin, metformin, and statins against gastric cancer, one of the most common cancers in the world, have been reported. This retrospective cohort study aimed to investigate independent associations of aspirin, metformin, and statin use with gastric cancer incidence and mortality after adjustment for concomitant use of other drugs, using pooled cohort data extracted from the Korean National Health Insurance claim database. Follow-up started on January 1, 2004 and ended at the date of gastric cancer diagnosis, death, or December 31, 2013. Exposures to drugs were defined as cumulative duration of use for aspirin and cumulative defined daily dose for metformin and statin and were entered as time-dependent variables in Cox analysis models to avoid immortal time bias. Use of aspirin longer than 182.5 and 547.5 days during two-year interval was associated with reduced risks of gastric cancer incidence and mortality, respectively. Diabetic patients were at higher risk of gastric cancer incidence and mortality than non-diabetic people, regardless of metformin treatment. However, metformin use among diabetic patients was associated with a reduction in gastric cancer mortality in a dose-response manner. Statin use was also associated with a reduction of gastric cancer mortality in the general population but not with gastric cancer incidence. In conclusion, long-term use of aspirin was independently associated with reduced incidence and mortality of gastric cancer in the general population, but metformin or statin use was only associated with a reduction of gastric cancer mortality in diabetic patients and in the general population, respectively.