Aspirin and lung cancer in women

Abstract

The association between aspirin use and lung cancer risk in women was examined in a case -control study nested in the New York University Women's Health Study, a large cohort in New York. Case subjects were all the 81 incident lung cancer cases who had provided information about aspirin use at enrollment and during the 1994 -1996 follow up. Ten controls per case were randomly selected from among study participants who matched a case by age, menopausal status, and dates of enrollment and follow-up. Relative to no aspirin use, the odds ratio for lung cancer (all histological sub-types combined) among subjects who reported aspirin use three or more times per week for at least 6 months was 0.66 (95% confidence interval 0.34 -1.28), after adjustment for smoking and education. A stronger inverse association was observed in analyses restricted to non-small cell lung cancer (adjusted odds ratio 0.39, 95% confidence interval 0.16 -0.96). These results suggest that regular aspirin use might be inversely associated with risk of lung cancer in women, particularly the non-small cell sub-type. British Journal of Cancer (2002) A role for nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing lung carcinogenesis is suggested by animal models, in which aspirin and other NSAIDs inhibited the formation of chemically-induced lung tumours (Jalbert and Castonguay, 1992;Castonguay et al, 1998;Rioux and Castonguay, 1998).The relation between NSAIDs use and lung cancer has been examined in at least six epidemiological studies published to date. In a trial of aspirin among British physicians, there were fewer lung cancer deaths among aspirin users compared with nonusers (Peto et al, 1988). In two prospective studies, no overall association was observed between aspirin use and lung cancer, although when stratified by gender, regular aspirin use appeared to be inversely associated with lung cancer incidence (Paganini-Hill et al, 1989) and mortality (Thun et al, 1993) in women. In a prospective study based on the first National Health and Nutrition Examination Survey, self-reported use of aspirin during the 30-day period preceding a subject's recruitment into the cohort was associated with a significant reduction in lung cancer incidence compared with nonuse (Schreinemachers and Everson, 1994). Two case -control studies found no significant associations between aspirin use and risk of lung cancer (Rosenberg, 1995;Langman et al, 2000).To assess further the potential effect of aspirin use on lung cancer risk, we analysed the data in a case -control study of lung cancer nested in the New York University (NYU) Women's Health Study cohort. MATERIALS AND METHODS Study populationThe NYU Women's Health Study is a long-term prospective cohort study that has been described in detail elsewhere (Toniolo et al, 1991, 1995). Briefly, between March 1985 and June 1991 mostly Caucasian women between ages of 31 and 70 years were enrolled at a mammography screening clinic in New York City. Women, who in the preceding 6 months had neither used hormonal m...

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

“…Overall, we found moderate increased risks of cancers of the prostate and kidney. We did not confirm a reduced risk of lung or breast cancer as reported in some studies (Schreinemachers and Everson, 1994;Harris et al, 1996Harris et al, , 1999Akhmedkhanov et al, 2002). Finally, our data support a reduced risk for ovarian cancer, which has also been reported among both users of paracetamol and aspirin (Cramer et al, 1998;Akhmedkhanov et al, 2001), and we observed a reduced risk of cervical cancer, although not among those with 10 or more prescriptions.…”

“…Two case -control studies (Rosenberg, 1995;Langman et al, 2000) reported no association between NSAIDs and lung cancer, but a third found a relative risk of 0.7 (95% CI 0.3 -1.3) among women taking aspirin for at least 6 months (Akhmedkhanov et al, 2002). We had no information on cigarette smoking in our population, and thus we cannot rule out that the small SIR elevations for lung cancer (similar in men and women) may be because of differential smoking rates among NSAID users.…”

Use of NSAIDs, smoking and lung cancer risk

“…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.…”

Aspirin use and lung cancer in men

“…These include residual confounding due to broad categories of smoking habits (Paganini-Hill et al, 1989;Schreinemachers and Everson, 1994;Langman et al, 2000;Akhmedkhanov et al, 2002;Moysich et al, 2002); misclassification due to a single assessment of aspirin use (Paganini-Hill et al, 1989;Schreinemachers and Everson, 1994;Harris et al, 2002); and small number of lung cancer cases observed (Peto et al, 1988;PaganiniHill et al, 1989;Schreinemachers and Everson, 1994;Akhmedkhanov et al, 2002).…”