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Associations of low-dose aspirin or other NSAID use with prostate cancer risk in the Danish Diet, Cancer and Health Study

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Abstract

Purpose

Epidemiologic studies suggest that use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce prostate cancer risk. We examined these associations overall and according to clinical and lifestyle parameters.

Methods

We identified male participants in the Danish Diet, Cancer and Health Study (n = 26,339), holding information on anthropometric measures and lifestyle factors. From Danish nationwide registries and medical records, we retrieved complete prescription histories and prostate cancer occurrence and characteristics. Cox regression was used to estimate hazard ratios (HRs) for prostate cancer associated with low-dose aspirin or nonaspirin NSAID use, overall and by clinical characteristics, anthropometric measures, and lifestyle factors.

Results

We identified 1,927 prostate cancer cases during a median follow-up of 17.0 years. Low-dose aspirin use was not associated with overall prostate cancer risk, but a reduced HR for nonaggressive prostate cancer (high use [≥ 1,825 tablets]: 0.79; 95% confidence interval (CI) 0.60–1.04) and an increased HR for aggressive disease (high use: 1.27; 95% CI 1.00–1.61) was observed with low-dose aspirin use. Long-term, high-intensity use (≥ 10 years with ≥ 0.25 defined daily doses/day) of nonaspirin NSAIDs was associated with an increased HR for prostate cancer (1.35, 95% CI 0.99–1.84), confined to localized and nonaggressive disease. No consistent variation in HRs was seen in analyses stratified by height, body mass index, smoking, and alcohol use.

Conclusion

Low-dose aspirin or other NSAID use was not associated with reduced prostate cancer risk, neither overall nor according to anthropometric measures, smoking, or alcohol use. The variation according to outcome characteristics warrants further investigation.

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Acknowledgments

The study was supported by a grant from the Danish Cancer Society (Grant No. R56-A3307-12-S2).

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Authors and Affiliations

  1. Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark

    Charlotte Skriver, Christian Dehlendorff, Signe Benzon Larsen, Anne Tjønneland & Søren Friis

  2. Department of Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark

    Michael Borre

  3. Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Ole Maaløes Vej 24, 2200, Copenhagen N, Denmark

    Klaus Brasso & Signe Benzon Larsen

  4. Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark

    Anne Tjønneland & Søren Friis

  5. Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 19, 5000, Odense C, Denmark

    Anton Pottegård & Jesper Hallas

  6. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43–45, 8200, Aarhus N, Denmark

    Henrik Toft Sørensen & Søren Friis

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  1. Charlotte Skriver
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  2. Christian Dehlendorff
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Corresponding author

Correspondence to Charlotte Skriver.

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Conflict of interest

Professor Sørensen does not report receiving fees, honoraria, grants, or consultancies. Department of Clinical Epidemiology is, however, involved in studies with funding from various companies as research grants to (and administered by) Aarhus University. Authors not named here have disclosed no conflicts of interest.

Ethical approval

The DCH Study was approved by relevant Scientific Committees and the Danish Data Protection Agency.

Informed consent

Informed consent was obtained from all participants to retrieve information from nationwide registries [14]. Approval for medical record review was granted by the Danish National Committee on Health Research Ethics.

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Skriver, C., Dehlendorff, C., Borre, M. et al. Associations of low-dose aspirin or other NSAID use with prostate cancer risk in the Danish Diet, Cancer and Health Study. Cancer Causes Control 31, 139–151 (2020). https://doi.org/10.1007/s10552-019-01252-5

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