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Cancer Causes & Control

, Volume 23, Issue 3, pp 431–444 | Cite as

Non-steroidal anti-inflammatory drugs and cancer incidence by sex in the VITamins And Lifestyle (VITAL) cohort

  • Theodore M. BraskyEmail author
  • John D. Potter
  • Alan R. Kristal
  • Ruth E. Patterson
  • Ulrike Peters
  • Maryam M. Asgari
  • Mark D. Thornquist
  • Emily White
Original paper

Abstract

Purpose

Use of non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the incidence of several cancers. A recent meta-analysis of randomized trials of aspirin reported a reduction in cancer mortality; however, few studies have investigated whether aspirin or other NSAIDs reduce overall cancer risk.

Methods

64,847 residents of western Washington State, aged 50–76, completed a baseline questionnaire in 2000–2002 and reported on their use of individual NSAIDs over the past 10 years. Behavior was categorized as non-use, low (<4 days/week or <4 years), and high (≥4 days/week and ≥4 years). Over 7 years of follow-up, 5,946 incident invasive cancer cases were identified. Multivariable proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI).

Results

Relative to non-use, high 10-year use of regular-strength NSAIDs was inversely associated with total cancer risk in men (HR 0.88, 95% CI: 0.79–0.97) and not associated with risk in women (HR 1.10, 95% CI: 0.96–1.25; p interaction <0.01). Use of regular-strength NSAIDs was strongly and inversely associated with colorectal cancer risk in men and women, but differentially associated with sex-specific risk of shared cancer sites other than colorectal cancer (men: HR 0.83, 95% CI: 0.71–0.97; women: HR 1.18, 95% CI: 0.97–1.44; p interaction < 0.01).

Conclusions

Long-term use of NSAIDs was associated with a reduced risk of total cancer among men and colorectal cancer among both sexes. Our findings do not support NSAID use for overall cancer prevention among women. Additional high-quality studies with long-term follow-up for cancer among women are needed before a public health recommendation can be made.

Keywords

Aspirin Ibuprofen Non-steroidal anti-inflammatory drugs Total cancer 

Notes

Acknowledgments

This work is supported by National Institutes of Health and National Cancer Institute grants R25-CA094880 and K05-CA154337.

Supplementary material

10552_2011_9891_MOESM1_ESM.docx (49 kb)
Supplementary material 1 (DOCX 49 kb)

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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Theodore M. Brasky
    • 1
    • 2
    Email author
  • John D. Potter
    • 1
    • 2
  • Alan R. Kristal
    • 1
    • 2
  • Ruth E. Patterson
    • 3
  • Ulrike Peters
    • 1
    • 2
  • Maryam M. Asgari
    • 4
  • Mark D. Thornquist
    • 1
    • 2
  • Emily White
    • 1
    • 2
  1. 1.The Fred Hutchinson Cancer Research Center, Cancer Prevention UnitSeattleUSA
  2. 2.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  3. 3.Department of Family and Preventive MedicineUniversity of California—San DiegoSan DiegoUSA
  4. 4.Kaiser Permanente Division of ResearchOaklandUSA

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