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

Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of hepatic and extrahepatic cancers, in particular those linked to obesity. In people with chronic liver disease, aspirin may confer protection against hepatocellular carcinoma (HCC). We explore the potential chemopr...

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Published in:BMC medicine 2024-12, Vol.22 (1), p.574-16, Article 574
Main Authors: Anson, Matthew, Poon, Jun Shang, Henney, Alex E, Riley, David, Ibarbaru, Gema H, Sieberhagen, Cyril, Cuthbertson, Daniel J, Alam, Uazman, Hydes, Theresa
Format: Article
Language:English
Subjects:
Adult
Aged
Aggregation
Alcoholics
Anti-platelets
Aspirin
Aspirin - therapeutic use
Blood platelets
Breast carcinoma
Cancer
Carcinoma, Hepatocellular - epidemiology
Carcinoma, Hepatocellular - prevention & control
Cardiovascular disease
Care and treatment
Clopidogrel
Cohort analysis
Collaboration
Colorectal cancer
Colorectal carcinoma
Complications and side effects
Demographic aspects
Diabetes
Diagnosis
Disease prevention
Electronic health records
Electronic medical records
Fatty liver
Female
Hepatocellular carcinoma
Humans
Incidence
Liver
Liver cancer
Liver cirrhosis
Liver diseases
Liver Neoplasms - epidemiology
Liver Neoplasms - prevention & control
Male
Medical records
Medical research
Medicine, Experimental
Metabolism
Middle Aged
Multiple myeloma
Neoplasms - epidemiology
Non-alcoholic fatty liver disease
Non-alcoholic Fatty Liver Disease - complications
Non-alcoholic Fatty Liver Disease - drug therapy
Non-alcoholic Fatty Liver Disease - epidemiology
Obesity
Obesity - complications
Obesity - drug therapy
Obesity - epidemiology
Ovarian cancer
Ovarian carcinoma
Ovaries
Pancreatic cancer
Pancreatic carcinoma
Patients
Platelet Aggregation Inhibitors - therapeutic use
Platelets
Prevention
Retrospective Studies
Risk factors
Sensitivity analysis
Statistical analysis
Subgroups
Thyroid gland
Type 2 diabetes
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Summary:Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of hepatic and extrahepatic cancers, in particular those linked to obesity. In people with chronic liver disease, aspirin may confer protection against hepatocellular carcinoma (HCC). We explore the potential chemoprotective effect of aspirin/other anti-platelet agents on obesity-related cancers, including HCC in people with NAFLD. We performed a retrospective cohort study of anonymised electronic medical records using the TriNetX network (Cambridge, MA, USA), a global federated database. We identified adults aged 18 or over with a diagnosis of NAFLD, prior to commencing antiplatelet agents. Two groups were created: antiplatelet (1) versus no antiplatelet use (2). We propensity score matched for nine variables. Antiplatelet use was defined as aspirin, ticagrelor, cangrelor, clopidogrel or prasugrel use for at least 1 year. The outcomes of interest were incidence of HCC and other obesity-related cancers. Follow-up was for 5 years. We performed subgroup analyses on aspirin users only and stratified findings for sex and age. Sensitivity analysis was conducted on individuals with 3- and 5-year aspirin exposure. Post matching, there were 42,192 people per group. Antiplatelet use in people with NAFLD was associated with statistically significant reduction in all obesity-related cancers (HR 0.71, 95% CI 0.65-0.78, p 
ISSN:1741-7015
1741-7015
DOI:10.1186/s12916-024-03802-4