Advertisement

Aspirin and Prostate Cancer Prevention

  • Cristina BosettiEmail author
  • Valentina Rosato
  • Silvano Gallus
  • Carlo La Vecchia
Chapter
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 202)

Abstract

Aspirin has been associated to a reduced risk of colorectal, and possibly of other cancers. Data from at least 25 observational studies also suggest a modest reduced risk of prostate cancer in regular aspirin users, with a summary relative risk, RR, of 0.91 (95 % confidence interval, CI, 0.86–0.96) overall, 0.87 (95 % CI 0.74–1.02) from nine case–control studies, and 0.92 (95 % CI 0.87–0.97) from 16 cohort studies. However, risk estimates are heterogeneous and there is no relation with frequency, dose, or duration of aspirin use. Data from randomized controlled trials of aspirin for the prevention of vascular events showed a nonsignificant reduced risk of death from prostate cancer after a latent period of five or more years (RR 0.52, 95 % CI 0.20–1.24) based on 37 deaths from prostate cancer from seven trials. The RR was 0.81 (95 % CI 0.61–1.06) after 20 years of follow-up, based on 210 cases from three trials with long-term follow-up. Thus, data from observational studies and clinical trials are compatible with a modest favorable effect of aspirin on prostate cancer. Inference for causality and public health implications are, however, far from conclusive given the heterogeneity of results and the lack of dose and duration-risk relationships. Data on prostate cancer survival are still limited and inconsistent.

Keywords

Aspirin Epidemiology Neoplasm Prostate Risk 

Notes

Acknowledgments

This work was conducted with the contribution of the Italian Association for Cancer Research (grant No. 10068).

References

  1. Algra AM, Rothwell PM (2012) Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials. Lancet Oncol 13(5):518–527PubMedCrossRefGoogle Scholar
  2. Bambace NM, Holmes CE (2011) The platelet contribution to cancer progression. J Thromb Haemost 9(2):237–249PubMedCrossRefGoogle Scholar
  3. Bosetti C, Talamini R, Negri E, Franceschi S, Montella M, La Vecchia C (2006) Aspirin and the risk of prostate cancer. Eur J Cancer Prev 15(1):43–45PubMedCrossRefGoogle Scholar
  4. Bosetti C, Rosato V, Gallus S, Cuzick J, La Vecchia C (2012a) Aspirin and cancer risk: a quantitative review to 2011. Ann Oncol 23(6):1403–1415PubMedCrossRefGoogle Scholar
  5. Bosetti C, Rosato V, Gallus S, La Vecchia C (2012b) Aspirin and urologic cancer risk: an update. Nat Rev Urol 9(2):102–110PubMedCrossRefGoogle Scholar
  6. Brown JR, DuBois RN (2005) COX-2: a molecular target for colorectal cancer prevention. J Clin Oncol 23(12):2840–2855PubMedCrossRefGoogle Scholar
  7. Camerer E, Qazi AA, Duong DN, Cornelissen I, Advincula R, Coughlin SR (2004) Platelets, protease-activated receptors, and fibrinogen in hematogenous metastasis. Blood 104(2):397–401PubMedCrossRefGoogle Scholar
  8. Choe KS, Cowan JE, Chan JM, Carroll PR, D’Amico AV, Liauw SL (2012) Aspirin use and the risk of prostate cancer mortality in men treated with prostatectomy or radiotherapy. J Clin Oncol 30(28):3540–3544PubMedCrossRefGoogle Scholar
  9. Cuzick J, Otto F, Baron JA, Brown PH, Burn J, Greenwald P et al (2009) Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement. Lancet Oncol 10(5):501–507PubMedCrossRefGoogle Scholar
  10. Dasgupta K, Di Cesar D, Ghosn J, Rajan R, Mahmud S, Rahme E (2006) Association between nonsteroidal anti-inflammatory drugs and prostate cancer occurrence. Cancer J 12(2):130–135PubMedGoogle Scholar
  11. Dhillon PK, Kenfield SA, Stampfer MJ, Giovannucci EL (2011) Long-term aspirin use and the risk of total, high-grade, regionally advanced and lethal prostate cancer in a prospective cohort of health professionals, 1988–2006. Int J Cancer 128(10):2444–2452PubMedCentralPubMedCrossRefGoogle Scholar
  12. Dhillon PK, Kenfield SA, Stampfer MJ, Giovannucci EL, Chan JM (2012) Aspirin use after a prostate cancer diagnosis and cancer survival in a prospective cohort. Cancer Prev Res (Phila) 5(10):1223–1228CrossRefGoogle Scholar
  13. Elwood PC, Gallagher AM, Duthie GG, Mur LA, Morgan G (2009) Aspirin, salicylates, and cancer. Lancet 373(9671):1301–1309PubMedCrossRefGoogle Scholar
  14. Garcia Rodriguez LA, Gonzalez-Perez A (2004) Inverse association between nonsteroidal anti-inflammatory drugs and prostate cancer. Cancer Epidemiol Biomarkers Prev 13(4):649–653Google Scholar
  15. Gay LJ, Felding-Habermann B (2011) Contribution of platelets to tumour metastasis. Nat Rev Cancer 11(2):123–134PubMedCrossRefGoogle Scholar
  16. Gupta S, Srivastava M, Ahmad N, Bostwick DG, Mukhtar H (2000) Over-expression of cyclooxygenase-2 in human prostate adenocarcinoma. Prostate 42(1):73–78PubMedCrossRefGoogle Scholar
  17. Habel LA, Zhao W, Stanford JL (2002) Daily aspirin use and prostate cancer risk in a large, multiracial cohort in the US. Cancer Control 13(5):427–434CrossRefGoogle Scholar
  18. Harris RE, Beebe-Donk J, Alshafie GA (2007) Cancer chemoprevention by cyclooxygenase 2 (COX-2) blockade (Chapter 9). In: Harris RE (ed) Inflammation in the pathogenesis of chronic diseases. Springer, New York, pp 193–212Google Scholar
  19. Jacobs EJ, Thun MJ, Bain EB, Rodriguez C, Henley SJ, Calle EE (2007) A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence. J Natl Cancer Inst 99(8):608–615PubMedCrossRefGoogle Scholar
  20. Jacobs EJ, Newton CC, Gapstur SM, Thun MJ (2012) Daily aspirin use and cancer mortality in a large US cohort. J Natl Cancer Inst 104(16):1208–1217PubMedCrossRefGoogle Scholar
  21. Langley RE, Burdett S, Tierney JF, Cafferty F, Parmar MK, Venning G (2011) Aspirin and cancer: has aspirin been overlooked as an adjuvant therapy? Br J Cancer 105(8):1107–1113PubMedCentralPubMedCrossRefGoogle Scholar
  22. Liu X, Plummer SJ, Nock NL, Casey G, Witte JS (2006) Nonsteroidal antiinflammatory drugs and decreased risk of advanced prostate cancer: modification by lymphotoxin alpha. Am J Epidemiol 164(10):984–989PubMedCrossRefGoogle Scholar
  23. Mahmud SM, Franco EL, Aprikian AG (2010) Use of nonsteroidal anti-inflammatory drugs and prostate cancer risk: a meta-analysis. Int J Cancer 127(7):1680–1691PubMedCrossRefGoogle Scholar
  24. Mahmud SM, Franco EL, Turner D, Platt RW, Beck P, Skarsgard D et al (2011) Use of non-steroidal anti-inflammatory drugs and prostate cancer risk: a population-based nested case-control study. PLoS ONE 6(1):e16412PubMedCentralPubMedCrossRefGoogle Scholar
  25. Menezes RJ, Swede H, Niles R, Moysich KB (2006) Regular use of aspirin and prostate cancer risk (United States). Cancer Control 17(3):251–256CrossRefGoogle Scholar
  26. Perron L, Bairati I, Moore L, Meyer F (2003) Dosage, duration and timing of nonsteroidal antiinflammatory drug use and risk of prostate cancer. Int J Cancer 106(3):409–415PubMedCrossRefGoogle Scholar
  27. Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW (2011) Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet 377(9759):31–41PubMedCrossRefGoogle Scholar
  28. Rothwell PM, Price JF, Fowkes FG, Zanchetti A, Roncaglioni MC, Tognoni G et al (2012a) Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet 379(9826):1602–1612PubMedCrossRefGoogle Scholar
  29. Rothwell PM, Wilson M, Price JF, Belch JF, Meade TW, Mehta Z (2012b) Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. Lancet 379(9826):1591–1601PubMedCrossRefGoogle Scholar
  30. Salinas CA, Kwon EM, FitzGerald LM, Feng Z, Nelson PS, Ostrander EA et al (2010) Use of aspirin and other nonsteroidal antiinflammatory medications in relation to prostate cancer risk. Am J Epidemiol 172(5):578–590PubMedCrossRefGoogle Scholar
  31. Taketo MM (1998a) Cyclooxygenase-2 inhibitors in tumorigenesis (part I). J Natl Cancer Inst 90(20):1529–1536PubMedCrossRefGoogle Scholar
  32. Taketo MM (1998b) Cyclooxygenase-2 inhibitors in tumorigenesis (part II). J Natl Cancer Inst 90(21):1609–1620PubMedCrossRefGoogle Scholar
  33. Thun MJ, Henley SJ, Patrono C (2002) Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst 94(4):252–266PubMedCrossRefGoogle Scholar
  34. Veitonmäki T, Tammela TL, Auvinen A, Murtola TJ (2013) Use of aspirin, but not other non-steroidal anti-inflammatory drugs is associated with decreased prostate cancer risk at the population level. Eur J Cancer 49(4):938–945PubMedCrossRefGoogle Scholar
  35. Yoshimura R, Sano H, Masuda C, Kawamura M, Tsubouchi Y, Chargui J et al (2000) Expression of cyclooxygenase-2 in prostate carcinoma. Cancer 89(3):589–596PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Cristina Bosetti
    • 1
    Email author
  • Valentina Rosato
    • 1
  • Silvano Gallus
    • 1
  • Carlo La Vecchia
    • 1
    • 2
  1. 1.Department of EpidemiologyIRCCS—Istituto di Ricerche Farmacologiche “Mario Negri”MilanItaly
  2. 2.Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly

Personalised recommendations