2026/06/01 by Malene Söth Hansen, Lars Dyrskjøt, Uffe Heide‐Jørgensen +2 · 1 voice
Medicine · #Bladder and Urothelial Cancer Treatments #Urinary Tract Infections Management #Urinary and Genital Oncology Studies
paper · doi:10.1111/joim.70115
openalex publication_date 2026/06/01 · openalex created_date 2026/06/02 · openalex updated_date 2026/07/27
BACKGROUND: Whether aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) initiation may unmask unknown bladder cancers (BCs) by hematuria remains controversial. OBJECTIVES: To evaluate unmasking, we compared cystoscopy rates, BC prevalence at cystoscopy, and invasive stage prevalence at diagnosis in aspirin or NSAID initiators with never-users. METHODS: Using the Danish population-based registries, we identified all new aspirin or NSAID users in 2005-2023 and a matched never-using comparison cohort. Second, we identified all first-time cystoscopy recipients in 2005-2022 with aspirin or NSAID initiation within 1 year prior or never-use in 10 years preceding cystoscopy. Comparing these groups, we computed hazard ratios of cystoscopy during 1-year follow-up, prevalence ratios of BC at cystoscopy, and invasive stage disease at diagnosis. RESULTS: Among 50,771 aspirin initiators (median age: 67 years, 51% men) and 156,191 NSAID initiators (age: 45 years, 50% men) adjusted hazard ratios of cystoscopy were 1.54 (95% confidence interval [CI]: 1.38-1.72) and 1.56 (95% CI: 1.43-1.70) compared with never-users. Cystoscopy recipients included 683 aspirin (age: 70 years, 69% men) and 1414 NSAID initiators (age: 60 years, 63% men); standardized morbidity ratio weighted (SMRW) prevalence ratios were 0.97 (95% CI, 0.76-1.22) and 0.65 (95% CI, 0.51-0.82) compared with never-users. The SMRW invasive stage prevalence ratios were 0.81 (95% CI, 0.63-1.03) and 1.07 (95% CI, 0.85-1.34) in the aspirin and NSAID comparison. CONCLUSION: The combination of more cystoscopies and a lower prevalence of invasive stage at BC diagnosis may suggest the unmasking of asymptomatic BC in aspirin initiators. We did not find indications of unmasking with NSAID initiation.