Non-steroidal anti-inflammatory drugs and cancer incidence by sex in the VITamins And Lifestyle (VITAL) cohort
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Use of non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the incidence of several cancers. A recent meta-analysis of randomized trials of aspirin reported a reduction in cancer mortality; however, few studies have investigated whether aspirin or other NSAIDs reduce overall cancer risk.
64,847 residents of western Washington State, aged 50–76, completed a baseline questionnaire in 2000–2002 and reported on their use of individual NSAIDs over the past 10 years. Behavior was categorized as non-use, low (<4 days/week or <4 years), and high (≥4 days/week and ≥4 years). Over 7 years of follow-up, 5,946 incident invasive cancer cases were identified. Multivariable proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI).
Relative to non-use, high 10-year use of regular-strength NSAIDs was inversely associated with total cancer risk in men (HR 0.88, 95% CI: 0.79–0.97) and not associated with risk in women (HR 1.10, 95% CI: 0.96–1.25; p interaction <0.01). Use of regular-strength NSAIDs was strongly and inversely associated with colorectal cancer risk in men and women, but differentially associated with sex-specific risk of shared cancer sites other than colorectal cancer (men: HR 0.83, 95% CI: 0.71–0.97; women: HR 1.18, 95% CI: 0.97–1.44; p interaction < 0.01).
Long-term use of NSAIDs was associated with a reduced risk of total cancer among men and colorectal cancer among both sexes. Our findings do not support NSAID use for overall cancer prevention among women. Additional high-quality studies with long-term follow-up for cancer among women are needed before a public health recommendation can be made.
KeywordsAspirin Ibuprofen Non-steroidal anti-inflammatory drugs Total cancer
This work is supported by National Institutes of Health and National Cancer Institute grants R25-CA094880 and K05-CA154337.
- 11.Menzies D, Nair A, Meldrum KT, Hopkinson P, Lipworth BJ (2008) Effect of aspirin on airway inflammation and pulmonary function in patients with persistent asthma. J Allergy Clin Immunol 121:1184–1189Google Scholar
- 13.WCRF/AICR (2007) Food, nutrition and the prevention of cancer: a global perspective. AICR, WashingtonGoogle Scholar
- 16.Koenig W, Sund M, Frohlich M, Lowel H, Hutchinson WL, Pepys MB (2003) Refinement of the association of serum C-reactive protein concentration and coronary heart disease risk by correction for within-subject variation over time: the MONICA Augsburg studies, 1984 and 1987. Am J Epidemiol 158:357–364PubMedCrossRefGoogle Scholar
- 17.Bielecka-Dabrowa A, Goch JH, Mikhailidis DP, Rysz J, Maciejewski M, Banach M (2009) The influence of atorvastatin on parameters of inflammation and function of the left ventricle in patients with dilated cardiomyopathy. Med Sci Monit 15:MS12–MS23Google Scholar
- 18.Harris NL, Jaffe ES, Diebold J et al (1999) The World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues. Report of the Clinical Advisory Committee meeting, Airlie House, Virginia, November, 1997. Ann Oncol 10:1419–1432Google Scholar
- 26.Walter RB, Milano F, Brasky TM, White E (2011, in press) Long-term use of acetaminophen, aspirin, and other non-steroidal anti-inflammatory drugs and risk of hematologic malignancies: results from the prospective VITamins And Lifestyle (VITAL) study. J Clin Oncol 29(17):2424–2431Google Scholar
- 28.Takkouche B, Regueira-Mendez C, Etminan M (2008) Breast cancer and use of nonsteroidal anti-inflammatory drugs: a meta-analysis. J Natl Cancer Inst 100:1420–1423Google Scholar
- 31.Gonzalez-Perez A, Garcia Rodriguez LA, Lopez-Ridaura R (2003) Effects of non-steroidal anti-inflammatory drugs on cancer sites other than the colon and rectum: a meta-analysis. BMC Cancer 3:28Google Scholar
- 35.Adelman EE, Lisabeth L, Brown DL (2011) Gender differences in the primary prevention of stroke with aspirin. Women’s Health (London, England) 7:341–352; quiz 52–3Google Scholar