Aspirin Use and Lung, Colon, and Breast Cancer Incidence in a Prospective Study

Schreinemachers, Dina M.; Everson, Richard B.

doi:10.1097/00001648-199403000-00003

Cited by 646 publications

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“…Among them, eight reported an estimate in line with our observed 20% risk reduction (Thun et al, 1993;Schreinemachers and Everson, 1994;Harris et al, 1996; Neugut et al, 1998;Coogan et al, 1999;Harris et al, 1999;Cotterchio et al, 2001;Johnson et al, 2002). The other two studies found no effect (Egan et al, 1996;Anderson et al, 2002).…”

Section: Discussionsupporting

confidence: 69%

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Rodrı́guez

González‐Pérez

2004

Br J Cancer

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We conducted a cohort study with a nested case -control analysis to evaluate the effect of anti-inflammatory drugs in breast cancer incidence using the General Practice Research Database. Women taking aspirin and paracetamol for 1 year or longer had an odds ratio (OR) of 0.77 (95 percent confidence interval (95% CI): 0.62,0.95) and 0.76 (95% CI: 0.65,0.88), respectively, compared to nonusers. Daily doses of aspirin (75 mg) and paracetamol (up to 2000 mg) showed the greatest reduced risk. Use of non-aspirin nonsteroidal anti-inflammatory drugs for more than 1 year was not associated with a reduced risk of breast cancer (OR ¼ 1.00 (95% CI: 0.84, 1.17), and the corresponding estimate among users with at least 2 years duration was similar. Our findings suggest that aspirin at cardioprophylactic doses as well as paracetamol at analgesic doses is associated with a reduced risk of breast cancer. There is mounting epidemiological evidence suggesting that nonsteroidal anti-inflammatory drugs (NSAIDs) may substantially reduce the risk of colorectal cancer (Thun et al, 1991;García Rodríguez and Huerta-Á lvarez, 2000). The effects of NSAIDs in other cancers have also been extensively studied in the last decade. Nonsteroidal anti-inflammatory drugs have been shown to prevent breast cancer in animal models (Lala et al, 1997;Robertson et al, 1998). Proposed mechanisms commonly involve the inhibition of cyclooxygenase-2 (COX-2) (Sjodahl, 2001), the enzyme responsible for the production of various prostaglandins that play a key role in the proliferation of tumour tissue; there is accumulating evidence that NSAIDs may have the ability to restore apoptosis and inhibit angiogenesis (Thun et al, 2002).Observational studies of the effect of NSAIDs in breast cancer have shown inconclusive results through a meta-analysis, including data from 15 studies that concluded that NSAIDs could be associated with a small decrease in risk (Khuder and Mutgi, 2001). However, the association between breast cancer incidence and glucocorticoid therapy has been hardly explored. Results from in vitro studies suggest that glucocorticoids have a direct inhibitory effect on proliferation of mammary cancer cells (Goya et al, 1993). However, to our knowledge, this hypothesis has not been tested in an epidemiological study.We conducted a cohort study with a nested caseÀcontrol analysis to evaluate the effect of anti-inflammatory drugs in breast cancer incidence using the General Practice Research Database (GPRD). MATERIALS AND METHODSWe used data from the GPRD. This database contains computerised information entered by general practitioners (GPs) in the UK (García Rodríguez and Pérez Gutthann, 1998). Data on over two million patients are systematically recorded and sent anonymously to the Medicines and Healthcare products Regulatory Agency (MHRA), which collects and organises this information in order to be used for research projects. The computerised information includes demographics, details from general practitioner's visits, diagnoses from specialist's re...

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Section: Discussionsupporting

confidence: 69%

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Rodrı́guez

González‐Pérez

2004

Br J Cancer

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“…Likewise, four (Thun et al, 1991(Thun et al, , 1993Schreinemachers and Everson, 1994;Giovannucci et al, 1994Giovannucci et al, , 1995 out of five (Paganini-Hill et al, 1989;Paganini-Hill, 1994) cohort studies showed a protection of between 20% and 40% among regular aspirin users, although in the American Nurses' Health Study (Giovannucci et al, 1995) the protection was only evident for frequent use (2 four times per week) and after 20 years of use. Thus, the role of time factors, including latency, in the possible relationship between aspirin and colorectal cancer are not yet fully understood (Paganini-Hill, 1994;Greenberg and Baron, 1996).…”

mentioning

confidence: 97%

“…Likewise, four (Thun et al, 1991(Thun et al, , 1993Schreinemachers and Everson, 1994;Giovannucci et al, 1994Giovannucci et al, , 1995 out of five (Paganini-Hill et al, 1989;Paganini-Hill, 1994) (Paganini-Hill, 1994;Greenberg and Baron, 1996). In addition, few studies have investigated the potential confounding role of factors such as diet and exercise.…”

mentioning

confidence: 99%

Aspirin and colorectal cancer

Vecchia

Negri²,

Franceschi³

et al. 1997

Br J Cancer

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Summary The relationship between aspirin use and colorectal cancer risk was examined by a case-control study in Italy. Regular aspirin use was reported by only 47 (3.5%) cases and 77 (4.1%) control subjects, giving a multivariate odds ratio (OR) of 0.7 (95% Cl 0.5-1.0) after allowance for education, physical exercise and selected dietary factors.Keywords: aspirin; non-steroidal anti-inflammatory drugs; colorectal neoplasms; pharmacoepidemiology At least six case-control studies (Kune et al, 1988;Rosenberg et al, 1991;Suh et al, 1993;Muscat et al, 1994;Peleg et al, 1994), based on over 3700 cases, have suggested that the risk of colorectal cancer may be reduced in regular aspirin users. Likewise, four (Thun et al, 1991(Thun et al, , 1993Schreinemachers and Everson, 1994;Giovannucci et al, 1994Giovannucci et al, , 1995 out of five (Paganini-Hill et al, 1989;Paganini-Hill, 1994) (Paganini-Hill, 1994;Greenberg and Baron, 1996). In addition, few studies have investigated the potential confounding role of factors such as diet and exercise. We have therefore examined aspirin use and certain lifestyle factors in a case-control study in Italy. SUBJECTS AND METHODSThe data were derived from a case-control study of Correspondence to: C La Vecchia had been admitted to the same hospitals in which cases had been identified for acute conditions unrelated to known or likely risk factors for colorectal cancer. Of these, 23% had traumatic conditions, 27% acute non-traumatic orthopaedic disorders, 19% acute surgical conditions, 22% eye diseases and 9% miscellaneous other illnesses, such as ear, nose and throat and dental disorders.The structured questionnaire included information on personal characteristics, education and other socioeconomic factors, general lifestyle habits, such as smoking, alcohol and coffee consumption, a validated food frequency section (based on 79 foods, food groups or recipes; Franceschi et al, 1993), a few indicators of physical activity (occupational and leisure time), gynaecological and obstetric data, related medical history, and history of lifetime use of aspirin, including indication, time, frequency and duration of use before diagnosis of the disease which led to hospital admission. A comprehensive list of major aspirin-containing preparations (including most common combinations of multiple non-steroidal antiinflammatory drugs, NSAIDS) in Italy was supplied.Odds ratios (ORs) of colorectal cancer, and the corresponding 95% confidence intervals (CI), according to various measures of aspirin use were derived using unconditional multiple logistic regression (Breslow and Day, 1980), including terms for study centre, sex, quinquennia of age, education (< 7, 7-11, 2 12 years), marital status (never married, married), family history of colorectal cancer (yes/no), measures of energy intake (quintiles), alc!hol drinking (abstainer, plus tertiles), vegetable and meat intake (approximate tertiles) and an overall indicator of physical exercise (approximate tertiles). Table 1 gives the distribution of colorecta...

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“…There are at least seven cohort studies published to date that have evaluated the effect of aspirin or NSAIDs on colorectal carcinoma (Table 4). 40,[81][82][83][84][85][86] All but one of these studies 86 has shown a strong protective effect of NSAIDs.…”

Section: Human Observational Studiesmentioning

confidence: 99%

Chemoprevention of gastrointestinal malignancies with nonsteroidal antiinflammatory drugs

Shaheen

Straus

Sandler

2002

Cancer

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In multiple studies, the chronic use of nonsteroidal antiinflammatory drugs (NSAIDs) has been associated with a decreased incidence of several types of gastrointestinal (GI) neoplasia. This effect may be mediated by one of several intracellular mechanisms, some of which involve the inhibition of the cyclooxygenase-2 (COX-2) isoenzyme. In multiple studies of colorectal carcinoma, chronic NSAID use has shown a protective effect, with the majority of studies demonstrat-

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Aspirin Use and Lung, Colon, and Breast Cancer Incidence in a Prospective Study

Cited by 646 publications

References 0 publications

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Aspirin and colorectal cancer

Chemoprevention of gastrointestinal malignancies with nonsteroidal antiinflammatory drugs

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