Aspirin and Prostate Cancer Mortality: The Role of Tumor Grading Misclassification?
Authors: Teemu J. Murtola, Thea Veitonmäki
Journal: Annals of Internal Medicine (2019)

Editorials2 April 2019Aspirin and Prostate Cancer Mortality: The Role of Tumor Grading Misclassification?Teemu J. Murtola, MD, PhD and Thea Veitonmäki, MD, PhDTeemu J. Murtola, MD, PhDTampere University and Tampere University Hospital and Seinäjoki Central Hospital, Tampere and Seinäjoki, Finland (T.J.M.)Search for more papers by this author and Thea Veitonmäki, MD, PhDTampere University Hospital, Tampere, Finland (T.V.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0525 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their current Annals article, Skriver and colleagues report results from a Danish population-based cohort study estimating prostate cancer–specific survival by aspirin use among 29 136 patients with prostate cancer (1). Aspirin, also known as acetylsalicylic acid, has been linked to a decrease in prostate cancer risk (2) and, in some studies, prostate cancer mortality (2). However, these associations have been controversial; thus, further study is needed.In theory, aspirin is a very interesting drug for preventing prostate cancer progression. It is a noncompetitive inhibitor of cyclooxygenase enzyme 1 (COX-1) and also modifies the action of COX-2, an enzyme thought to ...References1. Skriver C, Dehlendorff C, Borre M, Brasso K, Larsen SB, Dalton SO, et al. Use of low-dose aspirin and mortality after prostate cancer diagnosis. A nationwide cohort study. Ann Intern Med. 2019;170:443-52. doi:10.7326/M17-3085 LinkGoogle Scholar2. Cuzick J, Thorat MA, Andriole G, Brawley OW, Brown PH, Culig Z, et al. Prevention and early detection of prostate cancer. Lancet Oncol. 2014;15:e484-92. [PMID: 25281467] doi:10.1016/S1470-2045(14)70211-6 CrossrefMedlineGoogle Scholar3. Shao N, Feng N, Wang Y, Mi Y, Li T, Hua L. Systematic review and meta-analysis of COX-2 expression and polymorphisms in prostate cancer. Mol Biol Rep. 2012;39:10997-1004. [PMID: 23053989] doi:10.1007/s11033-012-2001-5 CrossrefMedlineGoogle Scholar4. Platz EA, Kulac I, Barber JR, Drake CG, Joshu CE, Nelson WG, et al. A prospective study of chronic inflammation in benign prostate tissue and risk of prostate cancer: linked PCPT and SELECT cohorts. Cancer Epidemiol Biomarkers Prev. 2017;26:1549-1557. [PMID: 28754796] doi:10.1158/1055-9965.EPI-17-0503 CrossrefMedlineGoogle Scholar5. Bilani N, Bahmad H, Abou-Kheir W. Prostate cancer and aspirin use: synopsis of the proposed molecular mechanisms. Front Pharmacol. 2017;8:145. [PMID: 28377721] doi:10.3389/fphar.2017.00145 CrossrefMedlineGoogle Scholar6. Menter DG, Kopetz S, Hawk E, Sood AK, Loree JM, Gresele P, et al. Platelet “first responders” in wound response, cancer, and metastasis. Cancer Metastasis Rev. 2017;36:199-213. [PMID: 28730545] doi:10.1007/s10555-017-9682-0 CrossrefMedlineGoogle Scholar7. Murtola TJ, Pennanen P, Syvälä H, Bläuer M, Ylikomi T, Tammela TL. Effects of simvastatin, acetylsalicylic acid, and rosiglitazone on proliferation of normal and cancerous prostate epithelial cells at therapeutic concentrations. Prostate. 2009;69:1017-23. [PMID: 19301305] doi:10.1002/pros.20951 CrossrefMedlineGoogle Scholar8. Veitonmäki T, Murtola TJ, Määttänen L, Taari K, Stenman UH, Tammela TL, et al. Use of non-steroidal anti-inflammatory drugs and prostate cancer survival in the Finnish prostate cancer screening trial. Prostate. 2015;75:1394-402. [PMID: 26073992] doi:10.1002/pros.23020 CrossrefMedlineGoogle Scholar9. Chubak J, Whitlock EP, Williams SB, Kamineni A, Burda BU, Buist DSM, Anderson ML. U.S. Preventive Services Task Force evidence summary: aspirin use to prevent cancer. Accessed at www.uspreventiveservicestaskforce.org/Page/Document/evidence-summary-aspirin-to-prevent-cancer/aspirin-to-prevent-cardiovascular-disease-and-cancer on 14 February 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: Tampere University and Tampere University Hospital and Seinäjoki Central Hospital, Tampere and Seinäjoki, Finland (T.J.M.)Tampere University Hospital, Tampere, Finland (T.V.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0525.Corresponding Author: Teemu J. Murtola, MD, PhD, Tampere University, Faculty of Medicine and Health Technology, FM1 Building, 3rd Floor, Teiskontie 35, PL 2000, Tampere 33521, Finland; e-mail, teemu.[email protected]fi.Current Author Addresses: Dr. Murtola: Tampere University, Faculty of Medicine and Health Technology, FM1 Building, 3rd Floor, Teiskontie 35, PL 2000, Tampere 33521, Finland.Dr. Veitonmäki: Tampere University Hospital, Department of Urology, Teiskontie 35, PL 2000, Tampere 33521, Finland.This article was published at Annals.org on 5 March 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Low-Dose Aspirin and Mortality After Prostate Cancer Diagnosis Charlotte Skriver , Christian Dehlendorff , Michael Borre , Klaus Brasso , Signe Benzon Larsen , Susanne Oksbjerg Dalton , Mette Nørgaard , Anton Pottegård , Jesper Hallas , Henrik Toft Sørensen , and Søren Friis Metrics 2 April 2019Volume 170, Issue 7Page: 499-500KeywordsAspirinCohort studiesColorectal cancerDisclosureDrugsEnzymesForecastingMortalityProstate cancerProstate diseases ePublished: 5 March 2019 Issue Published: 2 April 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...