We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Aspirin Use, Colorectal Cancer Survival, and Loss to Follow-up

Anna E. Coghill, MPH; Polly A. Newcomb, PhD, MPH; John D. Potter, MD, PhD
JAMA. 2009;302(23):2549-2550. doi:10.1001/jama.2009.1824.
Text Size: A A A
Published online


To the Editor: Dr Chan and colleagues1 reported the results of an observational study of nonsteroidal anti-inflammatory drug (NSAID) use in the Nurses' Health Study (NHS), in which a significant reduction in colorectal cancer–specific mortality was observed with regular postdiagnostic aspirin use (odds ratio, 0.71; 95% confidence interval, 0.53-0.95), but not with prediagnostic use.

We have concerns about the interpretation of these results because of patient losses to the study population. Research investigating the association between NSAID use and colorectal cancer survival should include all incident colorectal cancer cases to validly generalize results to the larger patient population. All study participants in the study by Chan et al1 belonged to the NHS cohort; in the colorectal cancer survival study, an NHS cohort member was identified as a diagnosed case of colorectal cancer via the biennial mailed questionnaire. After noting diagnosis of colorectal cancer in the biennial questionnaire, study participants then had to consent to release of medical and pathology records for use in the present study. Due to the potential for significant lag time between diagnosis of colorectal cancer in NHS cohort members and entry into the present study as a participant, a number of colorectal cancer patients may have died before being detected. The result is that information, including both NSAID exposure and vital status, may have been lost from the study.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




December 16, 2009
Andrew T. Chan, MD, MPH; Shuji Ogino, MD, PhD; Charles S. Fuchs, MD, MPH
JAMA. 2009;302(23):2549-2550. doi:10.1001/jama.2009.1825.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.