Effect of Aspirin on Cancer Chemoprevention in Japanese Patients With Type 2 Diabetes: 10-Year Observational Follow-up of a Randomized Controlled Trial
Authors: Sadanori Okada, Takeshi Morimoto, Hisao Ogawa, Mio Sakuma, Chisa Matsumoto, Hirofumi Soejima, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Yoshihiko Saito, Kimiaki Miwa, Kazunobu Akahoshi, Kenji Misumi, Haruo Araki, Yutaka Mitsudo, Norifumi Kondo, Kenichi Ashihara, Shinya Yumoto, Masashi Horimoto, Osamu Doi, Kenichi Doijiri, Ryo Fukami, Michio Shimabukuro, Genshi Egusa, Kazuo Goto, Yoichi Hanaoka, Yoshihiro Kimura, Yoshikuni Haraguchi, Osamu Haraguchi, Atsushi Hasegawa, Yoshiko Shioya, Yosuke Shioya, Eiitiro Tanaka, Kazuhiko Yamada, Toshiya Atsumi, Satoshi Tanazawa, Yutaka Horio, Seishi Ichihara, Isao Yasuda, Tsuneo Ikeda, Makoto Ikemura, Chieko Imamoto, Yoshihisa Iseri, Ken Iwai, Shinya Okamoto, Seigo Sugiyama, Masanori Kamura, Hirofumi Kan, Mayumi Kiyota, Kyousuke Kawamura, Takashi Ono, Takeshi Koga, Etsuo Kinuwaki, Hiromichi Naito, Kazuo Kozuma, Kiyotaka Kudou, Yasuhiro Morikami, Hirofumi Yasue, Yuji Mizuno, Hisao Fujimoto, Kozaburo Matsuyama, Hiromi Fujii, Syuichi Kamijikkoku, Tetsuo Kuwahara, Kyoji Takaoka, Kazuo Machii, Kazutaka Maeda, Keiji Mahara, Akira Maki, Naoki Manda, Kousuke Marutsuka, Naoki Sameshima, Toshihiro Gi, Terufumi Matsunaga, Syuichi Matsuo, Hiroto Okubo, Fuyuki Minagawa, Kotaro Minoda, Junichi Miyata, Takeshi Matsuo, Sueo Momosaki, Tetsuo Munakata, Tomoki Nakamura, Hisatoshi Nagano, Kazuto Goshi, Keisuke Sugimoto, Shojiro Naomi, Toshiaki Nasu, Hiroyuki Tanaka, Ryuji Sonoda, Keizo Kajiwara, Takafumi Odo, Hirofumi Ogata, Masayuki Ogihara, Tateo Ogura, Keishiro Oka, Eiji Kawashima, Eiji Oshima, Ken Ozaki, Seiji Ozawa, Hiroyuki Shono, Yasuhiro Sakamoto, Nobuko Sakurai, Chikashi Wakabayashi, Tomohiro Sawada, Junji Shibata, Hisashi Shimono, Akihiro Iemura, Akira Matsutani, Hisakazu Suefuji, Hiromichi Sugiyama, Jun Hokamaki, Kenichi Komori, Yoshimi Kinoshita, Hironori Murakami, Jun Hashiguchi, Yasuhiro Hashiguchi, Koryo Sawai, Atuko Hifumi, Koji Seo, Masamitsu Toihata, Koji Tokube, Hiroshi Ogawa, Fumishi Tomita, Madoka Taguchi, Toshio Tsubokura, Tatsuaki Tsuchiya, Kaoru Tsuda, Ryuichiro Tsurusaki, Kenji Obata, Katumi Watanabe, Raisuke Hayasida, Yutaka Ishibashi, Yoshiaki Osamura, Yoshito Yamanaka, Kazuhiro Sonoda, Taisuke Iwaoka, Hiromitsu Yokota, Motoki Yoshinari, Nanami Abe, Noriaki Ando, Hiroshi Bando, Takeshi Takami, Michiaki Doi, Yoshihiro Fujii, Masahiro Fukuda, Yoshiaki Fukuoka, Masayoshi Hamano, Minoru Takaoka, Hiromi Hasegawa, Ikuo Yabuta, Kenshi Higami, Satomi Higami, Akiko Yasuno, Yuriko Fujinaga, Yoko Onishi, Katsutoshi Yoshimura, Shigetoshi Minami, Takao Nakashima, Hiroaki Horie, Kazuko Horii, Norihiko Matsumura, Tetsuo Ikuno, Yoshiyuki Katsuyama, Shiro Uemura, Masao Kikukawa, Masao Kanauchi, Hideshi Kuzuya, Arata Iwasaki, Takehiko Koutani, Hisaharu Makino, Hiroshi Miki, Susumu Misugi, Masaki Naito, Masatoshi Naito, Yukitaka Nakano, Akira Nakatani, Fumihiko Nakatani, Manabu Horii, Matahiro Yabuta, Ayako Seno, Hiroyuki Kawata, Kenichi Samejima, Kenji Onoue, Rika Kawakami, Tomoya Nakano, Tomoya Ueda, Tsunenari Soeda, Yoko Kita, Fumitaka Inoue, Shigeru Yamano, Hajime Iwama, Hirokazu Sakan, Megumi Suzuki, Tadashi Kagoshima, Takehito Nakai, Toshio Hashimoto, Yoshiharu Nishitani, Yoshiyuki Kobayashi, Koichi Hoda, Kengo Fujiki, Junko Uejima, Yoshinobu Morikawa, Takahiro Kawano, Hideki Yamada, Kazuo Nishimoto, Kyouyuki Ohsumi, Nobushige Ote, Akiko Oya, Kimiaki Nishiura, Joji Masuda, Keiichiro Ban, Yusuke Kyoda, Izumi Sawada, Yoko Sawada, Koichi Okada, Akihiro Yazaki, Masakazu Hanatani, Toshio Sutani, Yuko Hiramori, Yuya Tanaka, Toshiro Igaki, Yukio Tomioka, Hideo Shiiki, Kiyotaka Sugihara, Motomu Hayashi, Yasunobu Sasaki, Yasuo Matsukura, Michiaki Ueda, Masakuni Ueyama, Hideto Uyama, Hiroharu Yamada, Kenichi Yamaga, Tamio Nakajima, Kazumi Yoshimoto, Midori Yoshimura
Journal: Diabetes Care (2018)

This study analyzed the efficacy of low-dose aspirin in cancer chemoprevention in patients with diabetes.This study was a posttrial follow-up of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial. Participants in the JPAD trial (2,536 Japanese patients with type 2 diabetes and without preexisting cardiovascular disease) were randomly allocated to receive aspirin (81 or 100 mg daily) or no aspirin. After that trial ended in 2008, we followed up with the participants until 2015, with no attempt to change the previously assigned therapy. The primary end point was total cancer incidence. We investigated the effect of low-dose aspirin on cancer incidence.During the median follow-up period of 10.7 years, a total of 318 cancers occurred. The cancer incidence was not significantly different between the aspirin and no-aspirin groups (log-rank, P = 0.4; hazard ratio [HR], 0.92; 95% CI, 0.73-1.14; P = 0.4). In subgroup analyses, aspirin did not affect cancer incidence in men, women, or participants aged ≥65 years. However, it decreased cancer incidence in participants aged <65 years (log-rank, P = 0.05; HR, 0.67; 95% CI, 0.44-0.99; P = 0.048). After adjusting for sex, hemoglobin A1c, smoking status, and administration of metformin and statins, aspirin significantly reduced cancer incidence in participants aged <65 years (adjusted HR, 0.66; 95% CI, 0.43-0.99; P = 0.04).Low-dose aspirin did not reduce cancer incidence in Japanese patients with type 2 diabetes.