Nested case–control study of the effects of non-steroidal anti-inflammatory drugs on breast cancer risk and stage

Sharpe, Colin; Jp, Collet; McNutt, Mary; Belzile, Éric; Boivin, Jacky; Ja, Hanley

doi:10.1054/bjoc.2000.1119

Cited by 157 publications

(109 citation statements)

References 33 publications

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“…Nine studies evaluated dose-response relation of NSAID use and breast cancer but only two studies reported significant doseresponse relation for duration (Coogan et al, 1999) and frequency (Sharpe et al, 2000) of NSAID use. In one study (Coogan et al, 1999) the highest reduction in breast cancer risk was reported for the category 'unknown years of use'.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer and NSAID use: a meta-analysis

2001

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Recent epidemiological studies suggest that non-steroidal anti-inflammatory drugs (NSAIDs) reduce the risk of several cancers including breast cancer. This meta-analysis examined the studies on NSAID use and breast cancer. The estimators of relative risk and associated variances, which have been adjusted for the greatest number of confounders, were abstracted and included in the meta-analysis. Combined estimators of relative risk (RR) were calculated using either fixed or random effect models. Meta-analyses were performed on 6 cohort studies (number of cases ranged from 14 to 2414) and 8 case–control studies (number of cases ranged from 252 to 5882). The combined estimate of relative risk was 0.82 (95% confidence interval [CI] = 0.75–0.89). The combined estimate for cohort studies was 0.78 (95% CI = 0.62–0.99) and was 0.87 (95% CI = 0.84–0.91) for case–control studies. The findings of this meta-analysis suggest that NSAID use may be associated with a small decrease in the risk of breast cancer. However, the available data are insufficient to estimate the dose–response effect for duration and frequency of use of any particular types of NSAID. © 2001 Cancer Research Campaign http://www.bjcancer.com

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Section: Discussionmentioning

confidence: 99%

Breast cancer and NSAID use: a meta-analysis

2001

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“…Although NSAIDs have been shown to reduce the risk of breast cancer (Sharpe et al, 2000), it is not known how they reduce this risk nor is it known what effect they have on established breast cancer. Both selective COX-2 (celecoxib) and non selective COX inhibition (ibuprofen) reduced the incidence and subsequent growth of primary breast tumours induced by 7,12-dimethylbenz(a)anthracene (DMBA) in female Sprague Dawley rats Harris et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Cyclo-oxygenase inhibition reduces tumour growth and metastasis in an orthotopic model of breast cancer

et al. 2002

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The effect of selective and non-selective cyclo-oxygenase inhibition on tumour growth and metastasis in an orthotopic model of breast cancer was investigated. 4T1 mammary adenocarcinoma cells were injected into the mammary fat pad of female BALB/c mice. When tumours reached a mean tumour diameter of 8.4+0.4 mm, mice were randomised into three groups (n=6 per group) and received daily intraperitoneal injections of the selective cyclo-oxygenase-2 inhibitor, SC-236, the non selective cyclo-oxygenase inhibitor, Indomethacin, or drug vehicle. Tumour diameter was recorded on alternate days. From 8 days after initiation of treatment, tumour diameter in animals treated with either SC-236 or indomethacin was significantly reduced relative to controls. Both primary tumour weight and the number of lung metastases were significantly reduced in the SC-236 and indomethacin treated mice. Microvessel density was reduced and tumor cell apoptosis increased in the primary tumour of mice treated with either the selective or non-selective cyclo-oxygenase inhibitor. In vitro, cyclo-oxygenase inhibition decreased vascular endothelial growth factor production and increased apoptosis of tumour cells. Our results suggest that cyclo-oxygenase inhibitors will be of value in the treatment of both primary and metastatic breast cancer.

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“…Only two studies provided evidence of significant trend of risk reduction with increasing exposure to NSAIDs (Coogan et al, 1999;Sharpe et al, 2000), but there were insufficient data to estimate the overall combined dose -response effect for either duration or frequency of use in the meta-analysis.…”

Section: Epidemiology Of Cox Inhibitor Use and Breast Cancer Incidencementioning

confidence: 99%

COX inhibitors and breast cancer

2006

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There is considerable evidence to suggest that prostaglandins play an important role in the development and growth of cancer. The enzyme cyclo-oxygenase (COX) catalyses the conversion of arachidonic acid to prostaglandins. In recent years, there has been interest in a possible role for COX inhibitors in the prevention and treatment of malignancy. Cyclo-oxygenase-2 (COX-2) is overexpressed in several epithelial tumours, including breast cancer. Preclinical evidence favours an antitumour role for COX inhibitors in breast cancer. However, the epidemiological evidence for an association is conflicting. Trials are being conducted to study the use of COX inhibitors alone and in combination with other agents in the chemoprevention of breast cancer, and in the neoadjuvant, adjuvant, and metastatic treatment settings. In evaluating the potential use of these agents particularly in cancer chemoprophylaxis, the safety profile is as important as their efficacy. Concern over the cardiovascular safety of both selective and nonselective COX-inhibitors has recently been highlighted. Breast cancer is the most common malignancy in women in industrialised nations and the second leading cause of female cancer-related mortality. Approximately 40 000 women develop breast cancer in the UK each year. The incidence of breast cancer has increased by two-thirds over the last 15 years. Mortality rates though have fallen by one-third, and this is likely to be due to earlier detection of breast cancer because of screening, and the increased use of adjuvant therapies. In recent times, the prospect of further improvements in mortality rates has grown with hope provided by new chemotherapy agents and monoclonal antibody therapy directed at cell surface molecules. But can we do even better for women with breast cancer using cheap and simple treatments that are in current use?Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of widely available, inexpensive medicines. The analgesic, antiinflammatory, antipyretic and antithrombotic effects of salicylate in willow bark and other plant extracts were recognised in ancient Egypt and Greece. These properties have been extensively exploited in numerous fields of clinical medicine since the 19th century, and in cancer patients primarily for analgesia.

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Nested case–control study of the effects of non-steroidal anti-inflammatory drugs on breast cancer risk and stage

Cited by 157 publications

References 33 publications

Breast cancer and NSAID use: a meta-analysis

Breast cancer and NSAID use: a meta-analysis

Cyclo-oxygenase inhibition reduces tumour growth and metastasis in an orthotopic model of breast cancer

COX inhibitors and breast cancer

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