Breast cancer and NSAID use: a meta-analysis

Abstract

Recent epidemiological studies suggest that non-steroidal anti-inflammatory drugs (NSAIDs) reduce the risk of several cancers including breast cancer. This meta-analysis examined the studies on NSAID use and breast cancer. The estimators of relative risk and associated variances, which have been adjusted for the greatest number of confounders, were abstracted and included in the meta-analysis. Combined estimators of relative risk (RR) were calculated using either fixed or random effect models. Meta-analyses were performed on 6 cohort studies (number of cases ranged from 14 to 2414) and 8 case–control studies (number of cases ranged from 252 to 5882). The combined estimate of relative risk was 0.82 (95% confidence interval [CI] = 0.75–0.89). The combined estimate for cohort studies was 0.78 (95% CI = 0.62–0.99) and was 0.87 (95% CI = 0.84–0.91) for case–control studies. The findings of this meta-analysis suggest that NSAID use may be associated with a small decrease in the risk of breast cancer. However, the available data are insufficient to estimate the dose–response effect for duration and frequency of use of any particular types of NSAID. © 2001 Cancer Research Campaign http://www.bjcancer.com

Pre-surgical study of the biological effects of the selective cyclo-oxygenase-2 inhibitor celecoxib in patients with primary breast cancer

“…No evidence of a dose-response relationship was found and some studies indicated that coxibs were also associated with a lower risk of breast cancer [8]. This large-scale meta-analysis is consistent with several smaller meta-analyses [9][10][11][12].…”

“…The mean age of the patients in the celecoxib arm was 68 years and in the no treatment arm 71 years. The median (range) tumour sizes were 19.5 mm (10-60) and 20mm (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), respectively. Fifty percent and 67% respectively were grade 3.…”

Evidence for colorectal cancer cell specificity of aspirin effects on NFκB signalling and apoptosis

“…Although there is evidence for a protective effect of NSAIDs against non-gastrointestinal cancers, the data are less convincing and the risk reduction much less. In breast cancer, reports show conflicting results and a recent meta-analysis revealed a risk reduction of only 13% in case -control studies (Khuder and Mutgi, 2001), considerably lesser than that in CRC. Similarly, in endometrial and ovarian cancer, the available evidence suggests that NSAIDs confer little, if any, protection (Cramer et al, 1998;Rosenberg et al, 2000;Fairfield et al, 2002;Meier et al, 2002).…”

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

“…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.…”

“…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.…”