Table 2.
Associations between Aspirin, NA-NSAIDS and cancer outcomes.
| Outcome | Study | No. of cases/total | MA metric | Estimates | 95%CI | No. of studies | Cohort | Case-control | Effects model | I2; Q test P value | Egger test P value |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Aspirin | |||||||||||
| Significant associations | |||||||||||
| Digestive system cancer incidence | Bosetti C, 2020 | 211,318/NA | RR | 0.73 | 0.69–0.78 | 113 | 37 | 76 | Random | 86.0 %; <0.001 | NA |
| Breast cancer | Ma, 2021 | 99,769/2,060,592 | RR | 0.94 | 0.91–0.97 | 42 | 27 | 15 | Random | 67.0 %; <0.001 | 0.016 |
| Cholangiocarcinoma | Lapumnuaypol, 2019 | NA/9,200,653 | OR | 0.56 | 0.32–0.96 | 5 | 1 | 4 | Random | 98.0 %; 0.00 | 0.42 |
| Colorectal cancer | Ye,2013 | 18,750/NA | RR | 0.74 | 0.64–0.83 | 12 | 12 | 0 | Fixed | 0.0 %; 0.545 | 0.119 |
| Endometrial cancer | Zhang, 2016 | 11,998/485,290 | RR | 0.93 | 0.88–0.99 | 12 | 6 | 6 | Random | 0.0 %; 0.550 | 0.125 |
| Esophageal cancer | Sivarasan N, 2013 | 2969/238,644 | OR | 0.671 | 0.526–0.856 | 9 | 1 | 8 | Random | 75.0 %; NA | 0.05 |
| Gastric cancer | Win TT, 2020 | NA | OR | 0.64 | 0.54–0.76 | 21 | 10 | 11 | Random | 96.0 %; <0.001 | NA |
| Liver cancer | Wang, 2022 | 41,953+NA/3,305,888 | OR | 0.54 | 0.44–0.66 | 18 | 16 | 2 | Random | 96.0 %; <0.001 | 0.501 |
| Lung cancer | Friederike, 2016 | 15,572/1,736,915 | RR | 0.87 | 0.79–0.95 | 20 | 7 | 10 | Random | 74.4 %; <0.001 | 0.0001 |
| Ovary cancer | Zhang, 2016 | 15,163/499,950 | RR | 0.89 | 0.83–0.96 | 22 | 8 | 14 | Random | 22.5 %; 0.168 | 0.004 |
| Prostate cancer | Shang, 2018 | 2,788,562/107,524,011(+NA) | RR | 0.93 | 0.89–0.96 | 34(1cross-section) | 17 | 16 | Random | 79.5 %; 0.00 | 0.537 |
| Pancreatic cancer | Bosetti C, 2020 | 12,193/NA | RR | 0.78 | 0.68–0.89 | 15 | 7 | 8 | Random | 84.0 %; <0.001 | 0.216 |
| Non-significant associations | |||||||||||
| Bladder cancer | Zhang, 2013 | 8422/800,139 | RR | 1.02 | 0.91–1.14 | 11 | 6 | 5 | NA | 48.7 %; 0.035 | 0.686 |
| CNS cancer | Liu, 2014 | 8704/442,933 | RR | 1.01 | 0.84–1.21 | 7a(1RCT) | 2 | 4 | Random | 78.8 %; <0.001 | 0.644 |
| Head and neck cancer | Tang, 2016 | 13,827/362,307 | OR | 0.93 | 0.79–1.10 | 10 | 2 | 8 | Random | 60.5 %; 0.002 | 0.255 |
| Kidney cancer | Choueiri, T, 2014 | 6665/345,554 | RR | 1.10 | 0.95–1.28 | 13 | 5 | 8 | Random | 65.5 %; <0.001 | 0.86 |
| Melanoma | Li, 2013 | NA/434,908 | RR | 0.97 | 0.86–1.08 | 10(1RCT) | 5 | 4 | Random | 66.8 %; 0.001 | 0.672 |
| Skin cancer | Muranushi, 2014 | 4663/120,278 | RR | 0.88 | 0.75–1.03 | 6 | 3 | 3 | Random | 63.7 %; 0.017 | 0.854 |
| NA-NSAIDS | |||||||||||
| Significant associations | |||||||||||
| CNS cancer | Zhang, 2017 | NA | RR | 0.86 | 0.78–0.94 | 10 | NA | NA | Random | 54.9 %; 0.001 | 1.000 |
| Colorectal cancer | Tomic, T, 2019 | NA/1,286,773 | OR | 0.74 | 0.67–0.81 | 23 | 10 | 13 | Random | 75.9 %; <0.001 | 0.08 |
| Esophageal cancer | Sun, 2011 | 877/NA | OR | 0.55 | 0.42–0.72 | 5 | 0 | 5 | Random | 2.2 %; 0.39 | 1.000 |
| Gastric cancer | Tian, 2010 | NA | RR | 0.81 | 0.74–0.90 | 6 | NA | NA | Fixed | 33.7 %; NA | 0.134 |
| Kidney cancer | Toni K, 2013 | 2230/303,067 | RR | 1.25 | 1.06–1.46 | 5 | 2 | 3 | Random | 27.3 %; 0.24 | 0.41 |
| Skin cancer | Muranushi, 2015 | 4449+NA/103,363 | RR | 0.85 | 0.78–0.94 | 7(1RCT) | 3 | 3 | Random | 0.0 %; 0.628 | 0.548 |
| Non-significant associations | |||||||||||
| Bladder cancer | Zhang, 2013 | 5663/764,146 | RR | 0.87 | 0.73–1.05 | 6 | 3 | 3 | Random | 79.3 %; 0.001 | 0.118 |
| Breast cancer | María, 2015 | NA | RR | 1.03 | 0.99–1.08 | 10 | 8 | 2 | Random | 43.6 %; NA | 0.416 |
| Endometrial cancer | Verdoodt, 2016 | 3275/389,301 | RR | 0.94 | 0.83–1.05 | 6 | 6 | 0 | Random | 22.4 %; 0.265 | 0.211 |
| Head and neck cancer | Saka-Herran, 2021 | 7663/1,217,905 | OR | 0.92 | 0.76–1.11 | 8 | 3 | 5 | Random | 82.0 %; <0.001 | NA |
| Liver cancer | Liu, 2022 | NA | HR | 0.95 | 0.80–1.15 | 4 | 4 | 0 | Random | 56.9 %; 0.073 | NA |
| Lung cancer | Xu, 2012 | 4066/26,310 | OR | 0.88 | 0.67–1.16 | 5 | 0 | 5 | Random | 93.0 %; <0.001 | NA |
| Melanoma | Li, 2013 | 5197+NA/431,382 | RR | 0.98 | 0.88–1.08 | 8 | 4 | 4 | Random | 59.1 %; 0.017 | 0.265 |
| Ovary cancer | Baandrup, 2013 | 9280/528,403 | RR | 0.94 | 0.84–1.06 | 16 | 6 | 10 | Random | 63.4 %; <0.01 | 0.91 |
| Pancreatic cancer | Zhang, 2015 | 981/118,444 | RRc | 1.08 | 0.89–1.31 | 3 | 2 | 1 | Random | 0.0 %; 0.676 | NA |
| Prostate cancer | Shang, 2018 | NA | RR | 1.00 | 0.91–1.10 | 15 | 7 | 8 | Random | 94.5 %; 0.000 | 0.953 |
NA-NSAIDS, Non-aspirin nonsteroidal anti-inflammatory drugs; MA, meta-analysis; CI, confidence interval; RR, relative risk; NA, not available; OR, odds ratio; CNS, central nervous system.