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Pre-diagnostic aspirin use and mortality after breast cancer

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Abstract

Background

Whether aspirin or other nonsteroidal anti-inflammation drug (NSAID) use is associated with mortality following breast cancer remains unclear. Consideration of use patterns and interaction with obesity may help to clarify the inconsistent results.

Methods

Pre-diagnosis NSAID use, weight, and height were assessed ~ 3 months after diagnosis through in-person interviews with a population-based cohort of 1,442 women with first primary breast cancer. Vital status was determined through the national death index after ~ 18 years of follow-up (N = 237/597 breast cancer-specific/all-cause deaths). We used Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Multiplicative interaction by body mass index (BMI) was evaluated using the likelihood ratio test.

Results

Ever aspirin use was inversely associated with breast cancer-specific mortality (HR 0.87, 95% CI 0.59–1.29), but positively associated with all-cause mortality (HR 1.21, 95% CI 0.99–1.48); the CIs included the null values. The HRs, however, were more pronounced for the highest level of duration, frequency, regularity, and timing for all-cause, but not breast cancer-specific mortality. Interactions with BMI revealed no significant heterogeneity (pinteraction = 0.37 and pinteraction = 0.36, respectively).

Conclusion

Pre-diagnosis aspirin use was not strongly associated with mortality following breast cancer. The all-cause mortality associations, however, were slightly stronger when we considered patterns of use.

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Acknowledgments

The study was supported in part by grants from the National Cancer Institute and the National Institute of Environmental Health Sciences (UO1CA/ES66572, U01CA66572).

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Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA

    Tengteng Wang, Humberto Parada, Kathleen M. McClain & Marilie D. Gammon

  2. Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, 94720, USA

    Patrick T. Bradshaw

  3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA

    Mary Beth Terry & Alfred I. Neugut

  4. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Susan L. Teitelbaum

  5. Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA

    Alfred I. Neugut

  6. Department of Epidemiology, UNC, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA

    Tengteng Wang

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  1. Tengteng Wang
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  2. Humberto Parada
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Correspondence to Tengteng Wang.

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Wang, T., Parada, H., McClain, K.M. et al. Pre-diagnostic aspirin use and mortality after breast cancer. Cancer Causes Control 29, 417–425 (2018). https://doi.org/10.1007/s10552-018-1020-5

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  • DOI: https://doi.org/10.1007/s10552-018-1020-5

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