Cancer Causes & Control

, 22:1709

Aspirin and NSAID use and lung cancer risk: a pooled analysis in the International Lung Cancer Consortium (ILCCO)

  • Valerie A. McCormack
  • Rayjean J. Hung
  • Darren R. Brenner
  • Heike Bickeböller
  • Albert Rosenberger
  • Joshua E. Muscat
  • Philip Lazarus
  • Anne Tjønneland
  • Søren Friis
  • David C. Christiani
  • Eun-mi Chun
  • Loic Le Marchand
  • Gad Rennert
  • Hedy S. Rennert
  • Angeline S. Andrew
  • Irene Orlow
  • Bernard Park
  • Paolo Boffetta
  • Eric J. Duell
Original paper

Abstract

Purpose

To investigate the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) lower lung cancer risk.

Methods

We analysed pooled individual-level data from seven case–control and one cohort study in the International Lung Cancer Consortium (ILCCO). Relative risks for lung cancer associated with self-reported history of aspirin and other NSAID use were estimated within individual studies using logistic regression or proportional hazards models, adjusted for packyears of smoking, age, calendar period, ethnicity and education and were combined using random effects meta-analysis.

Results

A total of 4,309 lung cancer cases (mean age at diagnosis 65 years, 45% adenocarcinoma and 22% squamous-cell carcinoma) and 58,301 non-cases/controls were included. Amongst controls, 34% had used NSAIDs in the past (81% of them used aspirin). After adjustment for negative confounding by smoking, ever-NSAID use (affirmative answer to the study-specific question on NSAID use) was associated with a 26% reduction (95% confidence interval 8 to 41%) in lung cancer risk in men, but not in women (3% increase (−11% to 30%)). In men, the association was stronger in current and former smokers, and for squamous-cell carcinoma than for adenocarcinomas, but there was no trend with duration of use. No differences were found in the effects on lung cancer risk of aspirin and non-aspirin NSAIDs.

Conclusions

Evidence from ILCCO suggests that NSAID use in men confers a modest protection for lung cancer, especially amongst ever-smokers. Additional investigation is needed regarding the possible effects of age, duration, dose and type of NSAID and whether effect modification by smoking status or sex exists.

Keywords

NSAIDs Aspirin Lung cancer 

Supplementary material

10552_2011_9847_MOESM1_ESM.doc (26 kb)
Supplementary material 1 (DOC 26 kb)

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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Valerie A. McCormack
    • 1
  • Rayjean J. Hung
    • 2
    • 3
  • Darren R. Brenner
    • 2
    • 3
  • Heike Bickeböller
    • 4
  • Albert Rosenberger
    • 4
  • Joshua E. Muscat
    • 5
  • Philip Lazarus
    • 5
  • Anne Tjønneland
    • 6
  • Søren Friis
    • 6
  • David C. Christiani
    • 7
  • Eun-mi Chun
    • 7
  • Loic Le Marchand
    • 8
  • Gad Rennert
    • 9
  • Hedy S. Rennert
    • 9
  • Angeline S. Andrew
    • 10
  • Irene Orlow
    • 11
  • Bernard Park
    • 11
    • 12
  • Paolo Boffetta
    • 13
    • 14
  • Eric J. Duell
    • 15
  1. 1.Section of Environment and RadiationInternational Agency for Research on CancerLyonFrance
  2. 2.Samuel Lunenfeld Research Institute of Mount Sinai HospitalTorontoCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  4. 4.Department of Genetic Epidemiology Medical SchoolGeorg-August-University of GöttingenGöttingenGermany
  5. 5.Pennsylvania State Cancer InstitutePennsylvania State College of MedicineHerseyUSA
  6. 6.Institute of Cancer EpidemiologyDanish Cancer SocietyCopenhagenDenmark
  7. 7.Harvard School of Public HealthMassachusetts General Hospital/Harvard Medical SchoolBostonUSA
  8. 8.Cancer Research Center of HawaiiUniversity of HawaiiHonoluluUSA
  9. 9.Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of MedicineIsrael Institute of Technology and Clalit Health Services National Cancer Control CenterHaifaIsrael
  10. 10.Norris Cotton Cancer Center, Department of Community & Family MedicineDartmouth Medical SchoolLebanonUSA
  11. 11.Department of Epidemiology and BiostatisticsMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  12. 12.Hackensack University Medical CenterHackensackUSA
  13. 13.Tisch Cancer Institute and Institute for Translational EpidemiologyMount Sinai School of MedicineNew YorkUSA
  14. 14.International Prevention Research InstituteLyonFrance
  15. 15.Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)Bellvitge Biomedical Research Institute (IDIBELL)BarcelonaSpain

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