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Association of aspirin and statin use with the risk of liver cancer in chronic hepatitis B: A nationwide population-based study

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Abstract
Background Aims Aspirin and statins have been suggested to prevent hepatocellular carcinoma (HCC). However, the combined effects of aspirin and statins on HCC risk in patients with chronic hepatitis B (CHB) are not clear. Methods A nationwide nested case-control study was performed with data from the National Health Insurance Service gathered between 2005 and 2015 in Korea. In a cohort of 538,135 treatment-naive, non-cirrhotic patients with CHB, 6,539 HCC cases were matched to 26,156 controls and were analysed by conditional logistic regression. Separate historical cohort studies for each drug were analysed by time-dependent Cox regression as a sensitivity analysis. Results In the nested case-control study, statins (OR 0.34; 95% CI 0.32-0.37) and aspirin (OR 0.92; 95% CI 0.85-0.99) were significantly associated with a HCC risk reduction. However, dose-dependent risk reduction was observed only with statins. By sensitivity analysis in the historical cohorts, statin users (n = 244,455; HR 0.67; 95% CI 0.66-0.68) and aspirin users (n = 288,777; HR 0.81; 95% CI 0.80-0.82) had significantly lower HCC risk. In the drug-stratified analyses, statins were associated with significantly reduced risk of HCC regardless of aspirin, whereas aspirin did not show such associations. Conclusions In this nationwide population-based study of patients with CHB, statin use was consistently associated with a significant and dose-dependent reduction in HCC risk. In contrast, the association between aspirin use and HCC risk reduction was not dose-dependent and was suggested to be confounded by statins.
Author(s)
최원묵김효정조애정최소현한승봉고민정임영석
Issued Date
2021
Type
Article
Keyword
anti-platelethepatitis B virushepatocellular carcinomalipid-lowering agentprevention
DOI
10.1111/liv.15011
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7223
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2550259728&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Association%20of%20aspirin%20and%20statin%20use%20with%20the%20risk%20of%20liver%20cancer%20in%20chronic%20hepatitis%20B:%20A%20nationwide%20population-based%20study&offset=0&pcAvailability=true
Publisher
LIVER INTERNATIONAL
Location
영국
Language
영어
ISSN
1478-3223
Citation Volume
41
Citation Number
11
Citation Start Page
2777
Citation End Page
2785
Appears in Collections:
Medicine > Medicine
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