Prediagnosis Obesity Eliminates Survival Advantage Associated With Aspirin Use in Stage IV Colorectal Cancer
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Prediagnosis Obesity Eliminates Survival Advantage Associated With Aspirin Use in Stage IV Colorectal Cancer

Douglas K. Rex, MD, MASGE, reviewing Davis JS, et al. JAMA Netw Open 2022 Oct 3.

This study divided 656 participants with stage IV colorectal cancer (CRC) into groups according to their prediagnosis body mass index (BMI): normal (38.3%), overweight (36.3%), and obese (25.4%). The investigators considered BMI in the 10 years prior to diagnosis. 

Overall, patients with obesity before CRC diagnosis had an increased risk of death compared with those with a normal prediagnosis BMI (hazard ratio, 1.48). Patients who had a normal BMI before diagnosis and consumed aspirin after diagnosis had a 41% lower risk of death than nonaspirin users, whereas obese patients did not experience a survival benefit from postdiagnosis aspirin use.

Douglas K. Rex, MD, FASGE

COMMENT

This study adds to previous research showing that obesity may negate the cancer prevention benefits of aspirin use, and it expands those results by demonstrating that prediagnosis obesity also may eliminate the postdiagnosis survival benefit of aspirin use. Increasing the dose of aspirin is potentially beneficial in obese patients, but there is some evidence that obesity increases the risk of aspirin-related ulcer.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Davis JS, Chavez JC, Kok M, et al. Association of prediagnosis obesity and postdiagnosis aspirin with survival from stage IV colorectal cancer. JAMA Netw Open 2022;5:e2236357. (https://doi.org/10.1001/jamanetworkopen.2022.36357)

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