Risk of cancer in a large cohort of nonaspirin NSAID users: a population-based study

Sørensen, Henrik Toft; Friis, Søren; Nørgård, Bente Mertz; Mellemkjær, Lene; Blot, William J.; Jk, McLaughlin; Ekbom, Anders; Baron, John A.

doi:10.1038/sj.bjc.6600945

Cited by 207 publications

(227 citation statements)

References 40 publications

(62 reference statements)

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“…Several epidemiologic studies have suggested that long-term users of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) have a lower risk of colorectal cancers compared to nonusers. [28][29][30] Although observations are less compelling NSAIDs may also have a protective effect against certain non-gastrointestinal cancer such as cancers of the lung, 31 prostate, 32 breast 31,33,34 and ovary. 29,35 The suggested inverse association between NSAIDs usage and cancer risk is compatible with the reduced risk of cancers of the digestive, respiratory and genital organs observed in the present investigation but not with the increased risk of breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Cancer risk among patients with multiple sclerosis: A population‐based register study

Nielsen

Rostgaard

Rasmussen

et al. 2005

Intl Journal of Cancer

122

144

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Cancer occurrence in patients with multiple sclerosis (MS) has been little studied, but associations with brain tumours, breast cancer, Hodgkin lymphoma and nasopharyngeal carcinoma have been suggested. We took advantage of population-based registers of MS and cancer to assess the risk of cancer following diagnosis of MS. Patients registered in the Danish Multiple Sclerosis Register were linked with the Danish Cancer Register to obtain information on cancer occurrence. The ratio of the observed to the number of expected cancers based on population-based incidence rates, i.e., the standardised incidence ratio (SIR), served as measure of the relative cancer risk. A database comprising all Danish women born after April 1, 1935, with information on all live-born children, was used in the analyses of breast cancer to adjust for reproductive factors.

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Section: Discussionmentioning

confidence: 99%

Cancer risk among patients with multiple sclerosis: A population‐based register study

Nielsen

Rostgaard

Rasmussen

et al. 2005

Intl Journal of Cancer

122

144

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“…We excluded retrospective analyses (Rosenberg 1995;Harris et al, 2002;Moysich et al, 2002;Muscat et al, 2003) because of potential biases in aspirin recall and selection of controls and the observed heterogeneity of results from case-control and cohort studies in previous reviews. We also excluded prospective studies that did not account for smoking (Paganini-Hill et al, 1989;Friis et al, 2003;Sorensen et al, 2003) or had no quantitative measure of aspirin use (Shreinemachers and Everson, 1994;Ratnasinghe et al, 2004) because these factors likely influence the association between aspirin and lung cancer. After exclusions, we identified nine studies that met our criteria for inclusion in the review (see Table 4).…”

Section: Literature Reviewmentioning

confidence: 99%

Aspirin and lung cancer risk in a cohort study of women: dosage, duration and latency

et al. 2007

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Aspirin may reduce the risk of cancer at some sites but its effect at the lung is unclear. We prospectively examined associations between aspirin use and risk of lung cancer in 109 348 women in the Nurses' Health study from 1980 to 2004. During this time, 1360 lung cancers were documented in participants 36 -82 years of age. Aspirin use and smoking were assessed every 2 years. Risk of lung cancer was a non-significant 16% lower for regular aspirin users of one or two tablets per week and a significant 55% higher for users of 15 or more tablets per week compared with women who never regularly used aspirin. Results were similar when limited to never smokers. For both the low and high quantity aspirin users, risk of lung cancer did not decline or increase with longer durations of use, and associations attenuated as the latency period between aspirin assessment and lung cancer diagnosis was lengthened. Our findings, together with those from previous clinical trials and prospective studies, do not provide consistent evidence that aspirin influences the development of lung cancer and further investigation is required with adjustment for smoking. British Journal of Cancer (2007) (Benamouzig et al, 2005), most likely through the inhibition of cyclooxygenase enzymes, restoration of normal apoptosis, and reduction of angiogenesis (Zha et al, 2004). However, the influence of aspirin at other tumour sites is less clear. For lung cancer, several meta-analyses with different coverage of published results have offered varying results and interpretations. Of the two that focused solely on lung cancer, aspirin users were found to have a significant 27% lower risk in one (Khuder et al, 2005) and a nonsignificant 9% lower risk in the other (Hernandez-Diaz and Rodriguez, 2007). In two other meta-analyses in which lung cancer was embedded in a wider review of many cancers, the first reported a 16% lower risk for aspirin users that was compatible with no effect or a slightly reduced risk (Gonzalez-Perez et al, 2003), and the other, limited to cohort studies, reported no association (Bosetti et al, 2006). In general, these meta-analyses concluded that a chemopreventive value of aspirin for lung cancer should be interpreted with caution owing to the limitations of the available studies and the heterogeneity of study designs and results. The authors called for larger studies with better exposure characterisation of dose -response measures and detailed adjustment for smoking. In an attempt to resolve these uncertainties, we examined relations between regular aspirin use and risk of invasive lung cancer among women in the Nurses' Health Study (NHS) cohort, taking into consideration quantity, frequency, and duration of use and latency between exposure and diagnosis, while controlling for detailed smoking characteristics. We placed our results within a wider context by conducting a literature review focused on clinical trials and prospective studies that, like our study, had a quantitative measure of aspirin use and controlled for smoking i...

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“…Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) used in relation to lung cancer have been investigated in at least 20 studies, including four hospital-based case -control studies (Rosenberg, 1995;Harris et al, 2002;Moysich et al, 2002;Muscat et al, 2003), fourteen cohort studies (Paganini-Hill et al, 1989;Thun et al, 1993;Schreinemachers and Everson, 1994;Langman et al, 2000;Akhmedkhanov et al, 2002;Friis et al, 2003;Holick et al, 2003;Sørensen et al, 2003;Ratnasinghe et al, 2004;Skriver et al, 2005;Hayes et al, 2006;Hernández-Diaz and Rodriguez, 2007;Jacobs et al, 2007;Wall et al, 2007) and three randomised trials (Peto et al, 1988;Lee et al, 1995;Cook et al, 2007). Significantly decreased risks were observed in three of the four hospital-based case -control studies (Rosenberg, 1995;Harris et al, 2002;Moysich et al, 2002), although all were based on selfreported drug use after diagnosis of cancer, raising the possibility of recall bias.…”

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confidence: 99%

Use of NSAIDs, smoking and lung cancer risk

et al. 2007

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We investigated the risk of lung cancer in relation to non-steroidal anti-inflammatory drugs (NSAIDs) among 573 cases and 857 sex-and age-matched controls for whom we had information on use of NSAIDs, from a prescription database covering all pharmacies in Denmark since 1995, and self-reported NSAID use, smoking habits and other potential confounders. Associations were expressed as odds ratios, assessed by logistic regression in unmatched analyses. After controlling for smoking habits, length of education and concomitant use of acetaminophen, we found a slightly decreased relative risk of 0.86 (95% confidence intervals, 0.65 -1.14) for lung cancer associated with any use of NSAIDs. The risk decreased significantly (P ¼ 0.02) with increasing numbers of dispensed prescriptions per year during the 1 -3 years before the index date with a relative risk of 0.49 (0.28 -0.84) among those with four or more prescriptions per year during this period. Our findings suggest that regular use of NSAIDs is associated with a slightly or moderately reduced risk for lung cancer.

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Risk of cancer in a large cohort of nonaspirin NSAID users: a population-based study

Cited by 207 publications

References 40 publications

Cancer risk among patients with multiple sclerosis: A population‐based register study

Cancer risk among patients with multiple sclerosis: A population‐based register study

Aspirin and lung cancer risk in a cohort study of women: dosage, duration and latency

Use of NSAIDs, smoking and lung cancer risk

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