Association Between Acetaminophen or Nonsteroidal Antiinflammatory Drugs and Risk of Developing Ovarian, Breast, or Colon Cancer

Meier, Christoph; Schmitz, Martine; Jick, Hershel

doi:10.1592/phco.22.5.303.33189

Cited by 88 publications

(90 citation statements)

References 31 publications

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“…Meier et al (2002)found that those with 30 paracetamol prescriptions or more had an OR of 0.8 (95% CI: 0.7, 1.0) compared to nonusers. Harris et al (1999) reported an OR of 0.84 among paracetamol users in a cohort of 32 505 women.…”

Section: Discussionmentioning

confidence: 99%

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Rodrı́guez

González‐Pérez

2004

Br J Cancer

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We conducted a cohort study with a nested case -control analysis to evaluate the effect of anti-inflammatory drugs in breast cancer incidence using the General Practice Research Database. Women taking aspirin and paracetamol for 1 year or longer had an odds ratio (OR) of 0.77 (95 percent confidence interval (95% CI): 0.62,0.95) and 0.76 (95% CI: 0.65,0.88), respectively, compared to nonusers. Daily doses of aspirin (75 mg) and paracetamol (up to 2000 mg) showed the greatest reduced risk. Use of non-aspirin nonsteroidal anti-inflammatory drugs for more than 1 year was not associated with a reduced risk of breast cancer (OR ¼ 1.00 (95% CI: 0.84, 1.17), and the corresponding estimate among users with at least 2 years duration was similar. Our findings suggest that aspirin at cardioprophylactic doses as well as paracetamol at analgesic doses is associated with a reduced risk of breast cancer. There is mounting epidemiological evidence suggesting that nonsteroidal anti-inflammatory drugs (NSAIDs) may substantially reduce the risk of colorectal cancer (Thun et al, 1991;García Rodríguez and Huerta-Á lvarez, 2000). The effects of NSAIDs in other cancers have also been extensively studied in the last decade. Nonsteroidal anti-inflammatory drugs have been shown to prevent breast cancer in animal models (Lala et al, 1997;Robertson et al, 1998). Proposed mechanisms commonly involve the inhibition of cyclooxygenase-2 (COX-2) (Sjodahl, 2001), the enzyme responsible for the production of various prostaglandins that play a key role in the proliferation of tumour tissue; there is accumulating evidence that NSAIDs may have the ability to restore apoptosis and inhibit angiogenesis (Thun et al, 2002).Observational studies of the effect of NSAIDs in breast cancer have shown inconclusive results through a meta-analysis, including data from 15 studies that concluded that NSAIDs could be associated with a small decrease in risk (Khuder and Mutgi, 2001). However, the association between breast cancer incidence and glucocorticoid therapy has been hardly explored. Results from in vitro studies suggest that glucocorticoids have a direct inhibitory effect on proliferation of mammary cancer cells (Goya et al, 1993). However, to our knowledge, this hypothesis has not been tested in an epidemiological study.We conducted a cohort study with a nested caseÀcontrol analysis to evaluate the effect of anti-inflammatory drugs in breast cancer incidence using the General Practice Research Database (GPRD). MATERIALS AND METHODSWe used data from the GPRD. This database contains computerised information entered by general practitioners (GPs) in the UK (García Rodríguez and Pérez Gutthann, 1998). Data on over two million patients are systematically recorded and sent anonymously to the Medicines and Healthcare products Regulatory Agency (MHRA), which collects and organises this information in order to be used for research projects. The computerised information includes demographics, details from general practitioner's visits, diagnoses from specialist's re...

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Section: Discussionmentioning

confidence: 99%

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Rodrı́guez

González‐Pérez

2004

Br J Cancer

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“…No information was available on over-the-counter (OTC) NSAID use (including that from non-pharmacy outlets) but there is little evidence of large-scale OTC purchasing of NSAIDs in the UK, especially in the middle aged and elderly. (Meier et al, 2002) Pancreatic cancer diagnoses were not validated and some misclassification of diagnoses may have occurred within the GPRD system but we excluded very elderly subjects, in which diagnostic accuracy may be a particular problem; also, all cancer codes were reviewed and cases with inconsistent coding were excluded. Furthermore, cancer diagnoses in GPRD appear to be a reliable record of incident cancer diagnoses and have been shown to concord with original medical records in 95% of cases.…”

Section: Discussionmentioning

confidence: 99%

Non-steroidal anti-inflammatory drugs and pancreatic cancer risk: a nested case–control study

et al. 2010

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BACKGROUND: Non-steroidal anti-inflammatory drug (NSAID) use has been linked with pancreatic cancer risk; however, findings from epidemiological studies are inconsistent. METHODS: A nested case -control study was conducted within the UK General Practice Research Database. Cases (n ¼ 1141) had a diagnosis of primary cancer of the exocrine pancreas between January 1995 and June 2006. Controls (n ¼ 7954) were matched with each case on general practice site, sex and year of birth. Conditional logistic regression analyses were used to generate odds ratios (OR) and 95% confidence intervals (CI) associated with NSAID use compared with non-use. RESULTS: Any use of NSAID in the 5 years before the index date or since entry into the database (excluding the year before diagnosis) was not associated with risk of pancreatic cancer; OR 0.96 (95% CI, 0.84 -1.10) and 1.03 (95% CI 0.89 -1.19), respectively. Exposure to NSAIDs for 4 773 days, in the 5 years pre-diagnosis, was associated with a reduced risk of pancreatic cancer OR 0.78 (95%CI 0.62 -0.97). There was evidence of reduced pancreatic cancer risk with long-term use (5 years or more) of lower doses of NSAIDs OR 0.70 (95% CI 0.49 -0.99). CONCLUSION: Long-term exposure to NSAIDs may be associated with a reduction in risk of pancreatic cancer.

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“…In contrast, a recent study reported an increased risk of pancreatic and prostate cancer among NSAID users (Langman et al, 2000). Data regarding the risk of lung, breast, and ovarian cancer among NSAID users are conflicting (Peto et al, 1988;Paganini-Hill et al, 1989;Schreinemachers and Everson, 1994;Egan et al, 1996;Harris et al, 1996Harris et al, , 1999Cramer et al, 1998;Akhmedkhanov et al, 2001;Moysich et al, 2001;Meier et al, 2002).…”

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confidence: 99%

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

et al. 2003

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There is increasing evidence of an inverse association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and risk of colorectal cancer. However, data regarding other cancer sites are limited. Using data from the population-based North Jutland Prescription Database and the Danish Cancer Registry, we compared cancer incidence among 172 057 individuals prescribed nonaspirin NSAIDs with expected incidence (based on county-specific cancer rates) during a 9-year study period. A total of 6081 incident cancer cases were diagnosed among NSAID users vs 5722 expected (standardised incidence ratio (SIR) 1.1, 95% confidence interval (CI)1.0 -1.1). The SIRs for colon and rectal cancer among persons who obtained 10 or more prescriptions were 0.7 (95% CI 0.6 -0.9) and 0.6 (95% CI 0.4 -0.9), respectively. Similarly, reduced risk estimates were found for stomach (SIR 0.7, 95% CI 0.4 -1.1) and ovarian cancer (SIR 0.7, 95% CI 0.4 -1.0). Standardised incidence ratios for other cancers among those with 10 or more prescriptions tended to be close to 1.0, except for lung, kidney, and prostate cancers with SIRs of 1.3 (95% CI 1.1 -1.6), 1.4 (95% CI 0.9 -2.1), and 1.6 (95% CI 1.3 -2.0), respectively. We found protective associations of NSAIDs against colon, rectal, stomach, and ovarian cancer. Reasons for the increased risk for some cancer sites are not clear.

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Association Between Acetaminophen or Nonsteroidal Antiinflammatory Drugs and Risk of Developing Ovarian, Breast, or Colon Cancer

Abstract: We found no evidence for a decreased ovarian cancer risk for women with regular acetaminophen or NSAID exposure.

Cited by 88 publications

References 31 publications

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Risk of breast cancer among users of aspirin and other anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs and pancreatic cancer risk: a nested case–control study

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

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