Aspirin and Non-Aspirin NSAID Use and Prostate Cancer Incidence, Mortality, and Case Fatality in the Atherosclerosis Risk in Communities Study

Abstract

Background: NSAIDs appear to moderately reduce prostate cancer risk. However, evidence is limited on whether NSAIDs protect against prostate cancer mortality (death from prostate cancer among men without a cancer history) and case fatality (death from prostate cancer among men with prostate cancer), and whether benefits are consistent in white and black men. This study investigated associations of aspirin and non-aspirin (NA) NSAID use with prostate cancer incidence, mortality, and case fatality in a population-based cohort of white and black men. Methods: We included 6,594 men (5,060 white and 1,534 black) from the Atherosclerosis Risk in Communities study without a cancer history at enrollment from 1987 to 1989. NSAID use was assessed at four study visits (1987-1998). Cancer outcomes were ascertained through 2012. Cox proportional hazards regression was used to estimate adjusted HRs, overall and by race. Results: Aspirin use was not associated with prostate cancer incidence. However, aspirin use was inversely associated with prostate cancer mortality [HR, 0.59; 95% confidence interval (CI), 0.36-0.96]. This association was consistent among white and black men and appeared restricted to men using aspirin daily and/or for cardiovascular disease prevention. Aspirin use was inversely associated with case fatality (HR, 0.45; 95% CI, 0.22-0.94). NA-NSAID use was not associated with these endpoints. Conclusions: Aspirin use was inversely associated with prostate cancer mortality and case fatality among white and black men. Impact: If confirmed by additional studies, benefits of aspirin for preventing prostate cancer mortality may need to be factored into risk-benefit calculations of men considering an aspirin regimen.

Could aspirin be a lifesaver for prostate cancer patients in prostate cancer-specific mortality?: an update systematic review and meta-analysis

“…These studies supported the protective influence of aspirin on PC patients and delayed the progression of PC. Hurwitz et al recently discovered that aspirin use was inversely associated with the risk of PCSM [12]. However, they found that aspirin did not effectively reduce the incidence of PC.…”

Immune Inflammation Pathways as Therapeutic Targets to Reduce Lethal Prostate Cancer in African American Men

“…Lastly, data prospectively obtained in the Southern Community Cohort Study suggested that aspirin use is tentatively associated with a reduced prostate cancer mortality in African American men [127]. Hurwitz et al also observed this inverse relationship between aspirin use and prostate cancer mortality in both African American and European American men using the ARIC cohort [128], again pointing to the potential benefit of aspirin use for men at high risk of fatal prostate cancer.…”

All about pain pharmacology: what pain physicians should know

“…In addition to the 4 representative therapeutic effects already mentioned, a low dose of ASA has been used for reducing the risk of heart attack and stroke [14]. Long-term medication for at least 10-20 years may be effective in cancer prevention, especially with colorectal cancer [15], but also with endometrial [16], breast [17], and prostate cancer [18].…”