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Aspirin in the aetiology of Crohn’s disease and ulcerative colitis: a European prospective cohort study

  1. S. S. M. Chan1,8,
  2. R. Luben2,
  3. M. M. Bergmann3,
  4. H. Boeing3,
  5. A. Olsen4,
  6. A. Tjonneland4,
  7. K. Overvad5,
  8. R. Kaaks6,
  9. H. Kennedy1,
  10. K.-T. Khaw2,
  11. E. Riboli7,
  12. A. R. Hart1,8

Article first published online: 26 JUL 2011

DOI: 10.1111/j.1365-2036.2011.04784.x

Issue

Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 34, Issue 6, pages 649–655, September 2011

Additional Information

How to Cite

Chan, S. S. M., Luben, R., Bergmann, M. M., Boeing, H., Olsen, A., Tjonneland, A., Overvad, K., Kaaks, R., Kennedy, H., Khaw, K.-T., Riboli, E. and Hart, A. R. (2011), Aspirin in the aetiology of Crohn’s disease and ulcerative colitis: a European prospective cohort study. Alimentary Pharmacology & Therapeutics, 34: 649–655. doi: 10.1111/j.1365-2036.2011.04784.x

Author Information

  1. 1

    Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.

  2. 2

    Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, UK.

  3. 3

    Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany.

  4. 4

    Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.

  5. 5

    Department of Clinical Epidemiology, University of Aarhus, Aarhus, Denmark.

  6. 6

    Division of Cancer Epidemiology, DKFZ-German Cancer Research Centre, Heidelberg, Germany.

  7. 7

    Division of Epidemiology, Imperial College London, London, UK.

  8. 8

    Norwich Medical School, University of East Anglia, Norwich, UK.

*Dr S. S. M. Chan, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK. E-mail: simon.chan@doctors.org.uk

Publication History

  1. Issue published online: 19 AUG 2011
  2. Article first published online: 26 JUL 2011
  3. Publication data Submitted 6 November 2010 First decision 14 December 2010 Resubmitted 2 July 2011 Accepted 4 July 2011 EV Pub Online 26 July 2011

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Aliment Pharmacol Ther 2011; 34: 649–655

Summary

Background  Aspirin has detrimental effects on the gastrointestinal tract mucosa and may play a role in the aetiology of inflammatory bowel disease.

Aim  To investigate if the regular use of aspirin is associated with the development of Crohn’s disease (CD) and ulcerative colitis (UC) using, for the first time, a prospective cohort study design.

Methods  A total of 135 780 men and women in Europe, aged 30–74 years, were recruited into the European Prospective Investigation into Cancer and Nutrition study. Participants completed questionnaires at baseline detailing their regular aspirin use and were then followed up to identify those who developed either incident CD or UC. Each case was matched with four controls and odds ratios (OR) were calculated, adjusting for cigarette smoking. Potential interactions between aspirin and smoking were assessed.

Results  A total of 35 participants developed CD and a further 84 were diagnosed with UC. Regular aspirin intake was positively associated with the risk of developing CD (OR = 6.14, 95% CI = 1.76–21.35). In those who took aspirin and smoked there was no detectable increased risk of CD (OR = 0.30, 95% CI = 0.03–3.08). No association was found between regular aspirin use and UC (OR = 1.29, 95% CI = 0.67–2.46).

Conclusions  A strong positive association between regular aspirin use and CD, but not UC, was observed. The data suggest that regular aspirin use should be measured in epidemiological work on CD. If such findings are consistent in other work then aspirin may affect the development of CD in a middle-aged to elderly population.

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