The chemoprotective effect of anti-platelet agents on cancer incidence in people with non-alcoholic fatty liver disease (NAFLD): a retrospective cohort study

Anson, Matthew; Poon, Jun Shang; Henney, Alex E.; Riley, David; Ibarbaru, Gema H.; Sieberhagen, Cyril; Cuthbertson, Daniel J.; Alam, Uazman; Hydes, Theresa

doi:10.1186/s12916-024-03802-4

Table 2 Summary of outcomes stratified for all antiplatelet and aspirin only users

From: The chemoprotective effect of anti-platelet agents on cancer incidence in people with non-alcoholic fatty liver disease (NAFLD): a retrospective cohort study

	All antiplatelets (n = 84,304)					Aspirin only (n = 56,440)
	Sample size	Outcome (n)	HR (95% confidence interval)	p value	E value	Sample size	Outcome (n)	HR (95% confidence interval)	p value	E value
*All obesity-related cancers*^a
Antiplatelet(s)	37,757	796	0.71 (0.65–0.78)	< 0.001	1.85	15,417	280	0.64 (0.55–0.74)	< 0.001	2.06
No antiplatelets	38,536	1033	0.71 (0.65–0.78)	< 0.001	1.85	15,421	407	0.64 (0.55–0.74)	< 0.001	2.06
*Hepatocellular carcinoma*
Antiplatelet(s)	41,799	89	0.52 (0.40–0.68)	< 0.001	2.52	27,953	48	0.46 (0.32–0.64)	< 0.001	2.80
No antiplatelets	41,941	156	0.52 (0.40–0.68)	< 0.001	2.52	28,061	99	0.46 (0.32–0.64)	< 0.001	2.80
*Colorectal carcinoma*
Antiplatelet(s)	41,292	162	0.68 (0.56–0.84)	< 0.001	1.94	27,564	93	0.63 (0.49–0.82)	0.001	2.10
No antiplatelets	41,406	217	0.68 (0.56–0.84)	< 0.001	1.94	27,710	138	0.63 (0.49–0.82)	0.001	2.10
*Pancreatic carcinoma*
Antiplatelet(s)	41,963	101	0.61 (0.47–0.78)	< 0.001	2.16	28,054	63	0.61 (0.45–0.84)	0.002	2.16
No antiplatelets	41,883	152	0.61 (0.47–0.78)	< 0.001	2.16	27,997	96	0.61 (0.45–0.84)	0.002	2.16
*Oesophageal carcinoma*
Antiplatelet(s)	41,119	26	0.70 (0.42–1.17)	0.174	1.00	28,169	16	0.58 (0.31–1.08)	0.082	2.27
No antiplatelets	41,093	34	0.70 (0.42–1.17)	0.174	1.00	28,150	26	0.58 (0.31–1.08)	0.082	2.27
*Gastric carcinoma*
Antiplatelet(s)	42,079	43	0.76 (0.50–1.13)	0.171	1.00	28,144	29	0.73 (0.45–1.19)	0.207	1.00
No antiplatelets	42,075	52	0.76 (0.50–1.13)	0.171	1.00	28,137	37	0.73 (0.45–1.19)	0.207	1.00
*Gallbladder carcinoma*
Antiplatelet(s)	42,162	10^b	0.66 (0.29–1.48)	0.305	1.00	28,197	10^b	0.62 (0.22–1.75)	0.365	1.00
No antiplatelets	42,156	14	0.66 (0.29–1.48)	0.305	1.00	28,195	10^b	0.62 (0.22–1.75)	0.365	1.00
*Ovarian carcinoma*
Antiplatelet(s)	41,979	58	0.87 (0.61–1.25)	0.443	1.00	28,061	41	0.85 (0.56–1.30)	0.457	1.00
No antiplatelets	42,004	61	0.87 (0.61–1.25)	0.443	1.00	28,089	45	0.85 (0.56–1.30)	0.457	1.00
*Uterine carcinoma*
Antiplatelet(s)	41,718	93	0.75 (0.57–0.98)	0.034	1.74	27,881	71	0.81 (0.59–1.11)	0.191	1.00
No antiplatelets	41,751	114	0.75 (0.57–0.98)	0.034	1.74	27,877	82	0.81 (0.59–1.11)	0.191	1.00
*Breast carcinoma*
Antiplatelet(s)	17,535	255	0.78 (0.66–0.92)	0.003	1.66	26,885	173	0.80 (0.65–0.97)	0.024	1.61
No antiplatelets	17,502	302	0.78 (0.66–0.92)	0.003	1.66	27,236	206	0.80 (0.65–0.97)	0.024	1.61
*Multiple myeloma*
Antiplatelet(s)	41,910	63	0.98 (0.68–1.39)	0.889	1.00	28,007	36	0.79 (0.50–1.22)	0.283	1.00
No antiplatelets	42,051	59	0.98 (0.68–1.39)	0.889	1.00	28,146	43	0.79 (0.50–1.22)	0.283	1.00
*Thyroid carcinoma*
Antiplatelet(s)	41,802	71	0.82 (0.60–1.13)	0.225	1.00	27,933	48	0.92 (0.62–1.36)	0.665	1.00
No antiplatelets	41,949	79	0.82 (0.60–1.13)	0.225	1.00	28,044	49	0.92 (0.62–1.36)	0.665	1.00

^aIndividuals were censored at the first coding of a constituent obesity-related malignancy composite outcome. The total number of individuals experiencing the composite outcome differ than that of the sum of the individual events because, to better ascertain the primary preventative effect of aspirin on all obesity-related malignancies, individuals with a history of any of the constituent events were excluded from analysis of the composite outcome
^bTriNetX implements several safeguards to minimise the risk of patient reidentification. To avoid the risk that a series of individual queries could identify small subsets of cohorts, when a query returns a patient count on an outcome where the patient count is ≤ 10 but greater than 0, the count is obfuscated to 10. The reported HR is calculated without this obfuscation present

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ISSN: 1741-7015

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