Prescriptions for selective cyclooxygenase-2 inhibitors, non-selective non-steroidal anti-inflammatory drugs, and risk of breast cancer in a population-based case-control study

Abstract

IntroductionNon-steroidal anti-inflammatory drugs (NSAIDs) prevent the growth of mammary tumours in animal models. Two population-based case-control studies suggest a reduced risk of breast cancer associated with selective cyclooxygenase-2 (sCox-2) inhibitor use, but data regarding the association between breast cancer occurrence and use of non-selective NSAIDs are conflicting.MethodsWe conducted a population-based case-control study using Danish healthcare databases to examine if use of NSAIDs, including sCox-2 inhibitors, was associated with a reduced risk of breast cancer. We included 8,195 incident breast cancer cases diagnosed in 1991 through 2006 and 81,950 population controls.ResultsOverall, we found no reduced breast cancer risk in ever users (>2 prescriptions) of sCox-2 inhibitors (odds ratio (OR) = 1.08, 95% confidence interval (95% CI) = 0.99, 1.18), aspirin (OR = 0.98, 95% CI = 0.90-1.07), or non-selective NSAIDs OR = 1.04, (95% CI = 0.98, 1.10)). Recent use (>2 prescriptions within two years of index date) of sCox-2 inhibitors, aspirin, or non-selective NSAIDs was likewise not associated with breast cancer risk (Ors = 1.06 (95% CI = 0.96, 1.18), 0.96 (95% CI = 0.87, 1.06) and 0.99 (95% CI = 0.85, 1.16), respectively). Risk estimates by duration (<10, 10 to 15, 15+ years) or intensity (low/medium/high) of NSAID use were also close to unity. Regardless of intensity, shorter or long-term NSAID use was not significantly associated with breast cancer risk.ConclusionsOverall, we found no compelling evidence of a reduced risk of breast cancer associated with use of sCox-2 inhibitors, aspirin, or non-selective NSAIDs.

The Role of NSAIDs in Breast Cancer Prevention and Relapse: Current Evidence and Future Perspectives

“…The same study also found no correlation between breast cancer risk and non-selective non-aspirin NSAIDs or aspirin (OR 0.98, 95% CI 0.90-1.07) [25]. The timing of non-selective non-aspirin NSAID or selective COX-2 inhibitor use did not influence breast cancer risk either [25]. …”

“…Selective COX-2 inhibitor use was not associated with breast cancer occurrence among individuals with (OR 1.12, 95% CI 0.86-1.44) or without (OR 1.07, 95% CI 0.98-1.17) a history of NSAID use before beginning selective COX-2 inhibitor use [25]. There was no evidence of a reduced risk of breast cancer among women who used selective COX-2 inhibitors only (ever use OR 1.09, 95% CI 0.98-1.22; recent use OR 0.99, 95% CI 0.80-1.23; former use OR 1.13, 95% CI 1.00-1.29) [25].…”

“…The conflicting evidence may be attributable to a combination of factors including poor precision and chance variation, low response rates with possible selection bias, short follow-up time, limited exposure data, or failure to distinguish between different NSAIDs subclasses [25]. …”

Targeting of COX-2 Expression by Recombinant Adenovirus shRNA Attenuates the Malignant Biological Behavior of Breast Cancer Cells

“…Experimental studies and clinical trials have demonstrated that COXIBs show antitumor activities in breast cancer and other tumors (Cervello et al, 2004;Fodera et al, 2004;Cusimano et al, 2007;Cronin-Fenton et al, 2010). However, the chemotherapy approach to cancer treatment is often hindered by the lack of specificity and side effects (Bombardier et al, 2000;Niederberger et al, 2004).…”

“…Furthermore, nonsteroidal anti-inflammatory drugs (NSAIDs) are beneficial in breast cancer therapy. The selective and non-selective inhibitors of COX2 such as aspirin, nimesulide and celecoxib were experimented as prevention and therapeutic agents against breast cancer and other tumors (Bresalier et al, 2005;Harris et al, 2005;Siegfried et al, 2007;Cronin-Fenton et al, 2010). Other research showed that nimesulide also could restrain the activity and expression of aromatase in some breast cancer cell lines (Su et al, 2009).…”