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

Feskanich, Diane; Bain, Chris; Chan, Andrew T.; Pandeya, Nirmala; Fe, Speizer; Colditz, Graham A.

doi:10.1038/sj.bjc.6603996

Cited by 32 publications

(21 citation statements)

References 26 publications

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“…Independent estimates from 18 studies were used in the meta-analysis of OTC NSAIDs and lung cancer (Peto et al, 1988;Schreinemachers and Everson, 1994;Langman et al, 2000;Paganini-Hill et al, 1989;Cook et al, 2005;Thun et al, 1993;Harris et al, 2002;Akhmedkhanov et al, 2002; Cyclooxygenase-2 (COX-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung 59 Moysich et al, 2002;Holick et al, 2003;Muscat et al, 2003;Ratnasinghe et al, 2002;Hayes et al, 2006;Hernandez-Diaz and Garcia Rodriguez, 2007;Feskanich et al, 2007;Kelly et al, 2008;Van Dyke et al, 2008). Relative risks and odds ratios with 95 % confidence intervals from these reports are shown in Figure 4.…”

Section: Lung Cancermentioning

confidence: 99%

Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung

2009

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The existing epidemiologic literature was comprehensively reviewed to retrieve all epidemiologic studies (case control and cohort studies) that examined exposure to traditional over the counter nonsteroidal anti-inflammatory drugs (OTC NSAIDs) and the risk of cancers of the colon, breast, prostate and lung from 1980 forward. These malignancies account for more that half of all cancer deaths in the United States and the United Kingdom. Estimates of effects (relative risks or odds ratios) and 95% confidence intervals were abstracted from these reports for meta-analysis. Regular intake of OTC NSAIDs produced highly significant composite risk reductions of 43% for colon cancer, 25% for breast cancer, 28% for lung cancer, and 27% for prostate cancer. Furthermore, in a series of case control studies, daily use of a selective COX-2 inhibitor, either celecoxib or rofecoxib, significantly reduced the risk for each of these malignancies. The evidence is compelling that anti-inflammatory agents with selective or non-selective activity against cycloooxygenase- 2 (COX-2) have strong potential for the chemoprevention of cancers of the colon, breast, prostate and lung. Results confirming that COX-2 blockade is effective for cancer prevention have been tempered by observations that some selective COX-2 inhibitors pose a risk to the cardiovascular system. Nevertheless, meta-analysis of independent estimates from 72 studies provides no evidence that the selective COX-2 inhibitor, celecoxib, influences the relative risk of cardiovascular disease (composite relative risk = 0.98, 95% CI = 0.88-1.10). Molecular studies reveal that over-expression of COX-2 is a prominent feature of premalignant and malignant neoplasms. Evidence is accumulating that carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive over-expression of COX-2 and the prostaglandin cascade in the "inflammogenesis of cancer".

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Section: Lung Cancermentioning

confidence: 99%

Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung

2009

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“…However, reported results of aspirin use and lung cancer risk are conflicting, with both protective [13][14][15][16][17][18][19][20][21] and null effects [22][23][24][25][26][27][28][29][30][31][32] being reported. Three clinical trials focusing on chemoprevention with aspirin reported non-significant protective effects [35][36][37], and a recent pooled analysis of individual-level data from 7 clinical trials of daily aspirin reported a protective effect on lung cancer death, with a protective latent period of about 5 years.…”

Section: Discussionmentioning

confidence: 99%

Aspirin and non-aspirin non-steroidal anti-inflammatory drug use and risk of lung cancer

Lim¹,

Chuah²,

Eng³

et al. 2012

Lung Cancer

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“…Of note, this study assessed the role of current NSAID use and did not report the association by duration of use. Other prospective observational studies including the Cancer Prevention Study, National Health and Nutrition Examination Study, the Nurses’ Health Study and Health Professional Follow-Up study did not report risk estimates by histologic subtypes (10–13). …”

Section: Discussionmentioning

confidence: 99%

“…Published cohort studies include the Vitamin and Lifestyle Study (VITAL), Iowa Women’s Health Study (IWHS), Health Professional Follow-Up Study (HPFS), National Health and Nutrition Examination Survey (NHANES), Cancer Prevention Study II (CPS) and the Nurses’ Health Study (NHS), which have reported hazard ratios ranging from 0.69 to 1.10 (8–13). The inconsistent results may be due to heterogeneity in exposure definition such as dosage, frequency, duration of use and adjusted covariates.…”

Section: Introductionmentioning

confidence: 99%

“…Preclinical studies show that female hormones may play a significant role in lung carcinogenesis (14, 15) and postmenopausal estrogen and progestin combination hormone use has been associated with increased lung cancer mortality in the Women’s Health Initiative (WHI) hormone therapy (HT) trial (16). In the CPS cohort, long term daily aspirin users were more likely to be HT users compared to non-aspirin users (41% vs. 30%) (12), and similarly in the NHS, current aspirin users were more likely to be HT users (36% vs. 28%) (13). This suggests that HT use may confound the association between NSAID use and lung cancer in studies which include postmenopausal women; thus HT may be an important covariate which needs to be adjusted when evaluating aspirin and NSAID use in relation to lung cancer risk in women.…”

Section: Introductionmentioning

confidence: 99%

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Nonsteroidal Anti-Inflammatory Drug and Aspirin Use in Relation to Lung Cancer Risk among Postmenopausal Women

Baik

Brasky

Pettinger

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Results from prospective studies suggest that non-steroidal anti-inflammatory drugs (NSAID) may decrease lung cancer risk; however, any protective effect appears to be most evident in men. Methods We evaluated the associations between NSAID use and lung cancer incidence in postmenopausal women in the Women’s Health Initiative (WHI) adjusting for female specific potential confounders such as hormone therapy in addition to smoking histories and other potential confounders. We identified 143,841 women from ages 50 to 79 and 1,902 centrally confirmed lung cancer cases were included in the analysis. We used Cox regression models to estimate hazard ratios and their 95% confidence intervals. Results Compared to non-use, regular NSAID use was not associated with overall lung cancer incidence (NSAID use >10 years HR 0.87, 95% CI 0.71–1.08, p-trend =0.13). No statistically significant associations were found when examined by histological subtypes and although there was a trend of decreased risk with longer duration of NSAID use in the adenocarcinoma subtype, this was not statistically significant (NSAID use >10 years HR 0.80, 95% CI 0.58–1.10, p trend = 0.07). Conclusion Our study did not show that NSAID use is associated with lung cancer risk in women even after adjusting for female-specific confounders. There was a trend of decreased risk in the adenocarcinoma subtype; however, this was not statistically significant. Impact Future studies will need to take in account the various molecular subtypes of non-small cell lung cancer to further elucidate the role of NSAIDS in lung cancer, especially for the adenocarcinoma subtype.

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

Cited by 32 publications

References 26 publications

Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung

Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung

Aspirin and non-aspirin non-steroidal anti-inflammatory drug use and risk of lung cancer

Nonsteroidal Anti-Inflammatory Drug and Aspirin Use in Relation to Lung Cancer Risk among Postmenopausal Women

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