Use of nonaspirin nonsteroidal anti‐inflammatory drugs and risk of head and neck cancer: A nationwide case–control study

Abstract

Head and neck cancer (HNC) is the sixth most frequent malignancy with high mortality and substantial morbidity and hence there is a need for identification of preventive factors. Preclinical and observational studies have reported antineoplastic effects of nonaspirin nonsteroidal anti‐inflammatory drugs (NSAIDs), but studies of nonaspirin NSAID use and risk of HNC are sparse and with inconsistent results. We therefore conducted a register‐based case–control study nested in the entire Danish population. Cases (n = 12,389) comprised all Danish residents aged 30–84 years with a histologically verified primary HNC diagnosis during 2000–2015. Based on the literature, cases were categorized into four groups of anticipated association with human papillomavirus (HPV): strong, potential, no/weak and uncertain. Age‐ and sex‐matched population controls (n = 185,835) were selected by risk‐set‐sampling. We obtained information on filled prescriptions of nonaspirin NSAIDs, other drug use, comorbid conditions and socioeconomic parameters from nationwide Danish registries. Ever‐use (≥2 prescriptions) of nonaspirin NSAIDs was not associated with the overall risk of HNC after adjustment for potential confounders (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.95–1.03). However, long‐term consistent use (≥5 years) was associated with a 25% reduction in HNC risk (OR: 0.75, 95% CI: 0.62–0.90). Stratified analyses by anticipated HPV‐association showed no material differences in estimates. In conclusion, ever‐use of nonaspirin NSAIDs was not associated with the risk of HNC with no apparent influence on the estimates by the anticipated HPV‐association. However, long‐term consistent use may be associated with a reduced risk of HNC and merits further investigation.

Causal association of serum biomarkers with oral cavity and oropharyngeal cancer: a mendelian randomization study

“…Previous studies have shown that the level of IL8 was associated with a worse overall survival in HNC patients [ 40 ]. Furthermore, a recent study found that consistent long-term use of non-steroidal anti-inflammatory drugs can be associated with a reduced risk of HNC [ 41 ]. One researcher found that anti-inflammatory drugs can reduce serum CRP [ 42 ].…”

Low‐dose aspirin use and risk of head and neck cancer—A Danish nationwide case–control study

“…We performed a nested case–control study based on nationwide Danish registries using the personal identification number assigned to all Danish residents as key identifier. The study design has previously been described 6 . From the Danish Cancer Registry, 7 we identified all patients (cases) aged 30–84 years at diagnosis with histologically verified squamous cell HNC during 2000–2015, restricted to invasive squamous cell carcinoma (International Classification of Diseases‐O‐3 morphology codes: 8050–8084 and 8121–8123 with 3 as 5 th digit).…”