Breast Cancer Research and Treatment

, Volume 109, Issue 3, pp 533–543 | Cite as

NSAID use and breast cancer risk in the VITAL cohort

  • Ann ReadyEmail author
  • Christine M. Velicer
  • Anne McTiernan
  • Emily White



We prospectively evaluated the association between average 10-year use of NSAIDs and invasive breast cancer.


Between 2000–2002, 35,323 postmenopausal women participating in the Vitamins And Lifestyle (VITAL) study provided detailed information regarding NSAID use, lifestyle and breast cancer risk factors. Using a Cox proportional hazards model, we analyzed associations between NSAID use and incident breast cancer (= 482) ascertained through linkage to the SEER cancer registry.


Use of low-dose aspirin at 4+ days/week over ten years was associated with a decreased risk of breast cancer (HR 0.65, confidence interval [CI] 0.43–0.97) versus no use, as was moderate use of other types of NSAIDs (HR 0.78, CI 0.61–0.98) for 10-yr average use up to 3 days/week. However, more frequent use of NSAIDs other than low–dose aspirin was associated with an increased risk (HR 1.26, CI 0.96–1.65), particularly frequent use of regular or extra strength aspirin (HR 1.43, CI 1.02–2.00).


We did not find evidence of a global protective effect of NSAID use for the development of breast cancer. However, long-term moderate use (frequent use of low doses or moderate frequency of high doses) was associated with reduced risk, while frequent use of higher dose products was associated with increased risk.


Aspirin Breast cancer Ibuprofen Non-steroidal anti-inflammatory drugs NSAIDs 



This publication was made possible by grant CA74846 from the National Cancer Institute and T32-AT00815 from the National Center for Complementary and Alternative Medicine (NCCAM). The authors wish to acknowledge Alyson Littman for her guidance on statistical analysis, Alan Kristal for his useful input on analysis and interpretation and Ilonka Evans for her data management.


  1. 1.
    Davies GL, Martin LA, Sacks N, Dowsett M (2002) Cyclooxygenase-2 (COX-2), aromatase and breast cancer: a possible role for COX-2 inhibitors in breast cancer chemoprevention. Ann Oncol 13(5):669–678PubMedCrossRefGoogle Scholar
  2. 2.
    Hwang D, Scollard D, Byrne J, Levine E (1998) Expression of cyclooxygenase-1 and cyclooxygenase-2 in human breast cells. J Natl Cancer Inst 90(6):455–460PubMedCrossRefGoogle Scholar
  3. 3.
    Abbadessa G, Spaccamiglio A, Sartori ML et al (2006) The aspirin metabolite, salicylate, inhibits 7, 12-dimethylbenz(a)anthracene-DNA adduct formation in breast cancer cells. Int J Oncol 28(5):1131–1140PubMedGoogle Scholar
  4. 4.
    Masferrer JL, Leahy KM, Koki AT et al (2000) Antiangiogenic and antitumor activities of cyclooxygenase-2 inhibitors. Cancer Res 60:1306–1311PubMedGoogle Scholar
  5. 5.
    Diaz-Cruz ES, Shapiro CL, Bruggemeier RW (2005) Cyclooxygenase inhibitors suppress aromatase expression and activity in breast cancer cells. J Clin Endocrinol Metab 90(5):2563–2570PubMedCrossRefGoogle Scholar
  6. 6.
    Leahy KM, Ornberg RL, Wang Y, Zweifel BS, Koki AT, Masferrer JL (2002) Cyclooxygenase-2 inhibition by celecoxib reduces proliferation and induces apoptosis in angiogenic endothelial cells in vivo. Cancer Res 62(3):625–631PubMedGoogle Scholar
  7. 7.
    Asano TK, McLeod RS (2006) Nonsteroidal anti-inflammatory drugs (NSAID) and aspirin for preventing colorectal adenomas and carcinomas. Cochrane Database Syst Rev 2Google Scholar
  8. 8.
    Huls G, Koornstra JJ, Kleibeuker JH (2003) Non-steroidal anti-inflammatory drugs and molecular carcinogenesis of colorectal carcinomas. Lancet 362(9379):230–232PubMedCrossRefGoogle Scholar
  9. 9.
    Schreinemachers DM, Everson RB (1994) Aspirin use and lung, colon, and breast cancer incidence in a prospective study. Epidemiology 5(2):133–135CrossRefGoogle Scholar
  10. 10.
    Harris RE, Kasbari S, Farra W (1999) Prospective study of nonsteroidal anti-inflammatory drugs and breast cancer. Oncol Rep 6:71–73PubMedGoogle Scholar
  11. 11.
    Johnson TW, Anderson KE, Lazovich D, Folsom AR (2002) Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. CEBP 11:1586–1591Google Scholar
  12. 12.
    Harris RE, Chlebowski RT, Jackson RD et al (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the Women’s Health Initiative. Cancer Res 63:6096–6101PubMedGoogle Scholar
  13. 13.
    Egan KM, Stampfer MJ, Giovannuccci E, Rosner BA, Colditz GA (1996) Prospective study of regular aspirin use and the risk of breast cancer. JNCI 88(14):988–942PubMedCrossRefGoogle Scholar
  14. 14.
    Marshall SF, Bernstein L, Anton-Culver H et al (2005) Nonsteroidal anti-inflammatory drugs use and breast cancer risk by stage and hormone receptor status. J NCI 97(11):805–812Google Scholar
  15. 15.
    Jacobs EJ, Thun MJ, Connell CJ et al (2005) Aspirin and other nonsteroidal anti-inflammatory drugs and breast cancer incidence in a large U.S. cohort. CEBP 14(1):261–264Google Scholar
  16. 16.
    Cook NR, Lee IM, Gaziano JM et al (2005) Low-dose aspirin in the primary prevention of cancer: The Women’s Health Study: a randomized controlled trial. JAMA 294(1):105–106CrossRefGoogle Scholar
  17. 17.
    Terry MB, Gammon MD, Zhang FF et al (2004) Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk. JAMA 291(20):2433–2440PubMedCrossRefGoogle Scholar
  18. 18.
    White E, Patterson RE, Krystal AR et al (2004) VITamins And Lifestyle Cohort study: study design and characteristics of supplement users. Am J Epidemiol 159(1):83–93PubMedCrossRefGoogle Scholar
  19. 19.
    Littman AJ, White E, Kristal AR, Patterson RE, Satia-About a J, Potter JD (2004) Assessment of a one-page questionnaire on long-term recreational physical activity. Epidemiology 15(1):105–113PubMedCrossRefGoogle Scholar
  20. 20.
    Baron JA, Cole BF, Sandler RS et al (2003) A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med 348(10):891–899PubMedCrossRefGoogle Scholar
  21. 21.
    Roussouw JE, Anderson GL, Prentice RL et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288(3):321–333CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Ann Ready
    • 1
    • 2
    Email author
  • Christine M. Velicer
    • 3
  • Anne McTiernan
    • 2
    • 3
  • Emily White
    • 2
    • 3
  1. 1.Bastyr University, Fred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  3. 3.Fred Hutchinson Cancer Research Center, Cancer Prevention UnitSeattleUSA

Personalised recommendations