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 4 Summary of outcomes of aspirin users stratified by sex (people prescribed aspirin monotherapy vs non-users of any antiplatelets)

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

	Male (n = 21,964)					Female (n = 31,584)
	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
Aspirin	10,271	125	0.71 (0.56–0.90)	0.004	1.85	13,469	346	0.77 (0.67–0.88)	< 0.001	1.69
No antiplatelets	10,441	162	0.71 (0.56–0.90)	0.004	1.85	13,999	437	0.77 (0.67–0.88)	< 0.001	1.69
*Hepatocellular carcinoma*
Aspirin	10,846	21	0.41 (0.24–0.68)	< 0.001	3.09	15,671	26	0.63 (0.38–1.03)	0.064	1.00
No antiplatelets	10,888	47	0.41 (0.24–0.68)	< 0.001	3.09	15,739	39	0.63 (0.38–1.03)	0.064	1.00
*Colorectal carcinoma*
Aspirin	10,690	39	0.71 (0.47–1.08)	0.103	1.00	15,463	49	0.65 (0.45–0.94)	0.019	2.03
No antiplatelets	10,738	50	0.71 (0.47–1.08)	0.103	1.00	15,546	71	0.65 (0.45–0.94)	0.019	2.03
*Pancreatic carcinoma*
Aspirin	10,909	36	0.82 (0.53–1.29)	0.397	1.00	15,709	22	0.41 (0.25–0.68)	< 0.001	3.09
No antiplatelets	10,902	40	0.82 (0.53–1.29)	0.397	1.00	15,678	50	0.41 (0.25–0.68)	< 0.001	3.09
*Oesophageal carcinoma*
Aspirin	10,949	10^b	1.01 (0.41–2.50)	0.979	1.00	15,776	10^b	0.67 (0.21–2.11)	0.488	1.00
No antiplatelets	10,947	10^b	1.01 (0.41–2.50)	0.979	1.00	15,780	10^b	0.67 (0.21–2.11)	0.488	1.00
*Gastric carcinoma*
Aspirin	10,604	13	0.70 (0.34–1.43)	0.321	1.00	15,754	15	0.83 (0.41–1.66)	0.595	1.00
No antiplatelets	10,593	17	0.70 (0.34–1.43)	0.321	1.00	15,769	17	0.83 (0.41–1.66)	0.595	1.00
*Gallbladder carcinoma*
Aspirin	10,969	10^b	0.46 (0.04–5.06)	0.514	1.00	15,783	10^b	0.78 (0.24–2.56)	0.681	1.00
No antiplatelets	10,973	10^b	0.46 (0.04–5.06)	0.514	1.00	15,775	10^b	0.78 (0.24–2.56)	0.681	1.00
*Ovarian carcinoma*
Aspirin	N/A					15,643	38	0.73 (0.48–1.11)	0.140	1.00
No antiplatelets	N/A					15,647	49	0.73 (0.48–1.11)	0.140	1.00
*Uterine carcinoma*
Aspirin	N/A					15,473	66	0.92 (0.66–1.30)	0.642	1.00
No antiplatelets	N/A					15,475	67	0.92 (0.66–1.30)	0.642	1.00
*Breast carcinoma*
Aspirin	10,959	10^b	2.70 (0.28–29.92)	0.371	1.00	14,558	160	0.76 (0.62–0.93)	0.009	1.71
No antiplatelets	10,970	10^b	2.70 (0.28–29.92)	0.371	1.00	14,915	202	0.76 (0.62–0.93)	0.009	1.71
*Multiple myeloma*
Aspirin	10,892	15	1.23 (0.57–2.68)	0.603	1.00	15,676	19	0.90 (0.48–1.68)	0.731	1.00
No antiplatelets	10,943	11	1.23 (0.57–2.68)	0.603	1.00	15,759	20	0.90 (0.48–1.68)	0.731	1.00
*Thyroid carcinoma*
Aspirin	10,920	13	1.08 (0.48–2.40)	0.859	1.00	15,584	32	1.00 (0.61–1.65)	0.988	1.00
No antiplatelets	10,953	11	1.08 (0.48–2.40)	0.859	1.00	15,682	30	1.00 (0.61–1.65)	0.988	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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