Effect of aspirin and other non-steroidal anti-inflammatory drugs on prostate cancer incidence and mortality: a systematic review and meta-analysis

Abstract

BackgroundIt has been postulated that non-steroidal anti-inflammatory drugs (NSAIDs) use leads to decreased prostate cancer (PCa) risk. In recent years, NSAIDs’ role in PCa development has been extensively studied; however, there is not yet a definitive answer. Moreover, the epidemiological results for NSAIDs’ effect on PCa-specific mortality have been inconsistent. Therefore, we performed a meta-analysis to examine the controversy.MethodsWe performed a literature database search and included all published studies conducted in the general population exposed to any NSAID, extracting an odds ratio (OR) or a hazard ratio (HR) with 95% confidence intervals (95% CIs) that compared the incidence of PCa or PCa-specific mortality with non-exposure. We derived a pooled OR or HR using random or fixed effects models, as appropriate. Subgroup analyses were also performed.ResultsThirty-nine studies (20 case–control and 19 cohort studies) were included in this analysis. Thirty-one studies were available concerning NSAID use and PCa incidence and eight studies on PCa-specific mortality. Compared to non-use, aspirin use was statistically significantly associated with PCa incidence risk, and the association was slightly stronger for advanced PCa than for total PCa (OR = 0.92, 95% CI = 0.87 to 0.97 for total PCa; OR = 0.81, 95% CI = 0.73 to 0.89 for advanced PCa). Aspirin use seems also to be associated with a modest reduction in PCa-specific mortality (HR = 0.86, 95% CI = 0.78 to 0.96 for total PCa; OR = 0.81, 95% CI = 0.71 to 0.92 for advanced PCa). Generally, the pooled effects for any NSAIDs, NA-NSAIDs and cyclooxygenase-2 inhibitors demonstrated no adverse or beneficial effects on PCa development or PCa-specific mortality, but the results were not consistent. The effect estimates did not vary markedly when stratified by study design and study quality but varied by geographic region. Furthermore, long-term aspirin use (≥4 years) was also significantly associated with reduced PCa incidence (OR = 0.88, 95% CI 0.79 to 0.99).ConclusionsThe present meta-analysis provides support for the hypothesis that aspirin use is inversely related to PCa incidence and PCa-specific mortality. The effect estimates, varying by geographic region, deserve further investigation.

Esophageal Adenocarcinoma: The Influence of Medications Used to Treat Comorbidities on Cancer Prognosis

“…[76][77][78][79][80][81][82] Specifically, post-diagnosis use of aspirin or non-aspirin NSAIDs is associated with statistically significant lower colorectal cancer-specific mortality, 76 (the phosphatidylinositol-4,5-bisphosphonate 3-kinase, catalytic subunit alpha polypeptide gene). 81 Post-diagnosis use of aspirin or non-aspirin NSAIDs may reduce risk of recurrence and/or cancer-specific mortality in patients with breast [83][84][85][86][87][88][89][90] and prostate [91][92][93][94][95][96] cancers; however, the results are somewhat conflicting and additional studies examining these associations across the different molecular subtypes of breast and prostate cancers may help clarify the role of these medications in patient outcomes. For esophageal cancer, the data are limited.…”

Prospected epigenetic moderators from natural sources and drug of class NSAIDS as effective treatment options to Prostate cancer

“…However, certain meta-analysis also suggested its association with an increased risk of prostate and other cancer [114] predicting its dubious therapeutic potential which is still needed to be stated adequately in the prospects to develop and use less toxic and economically affordable treatment option for cancer [115].…”

Controlling the melting transition of semi-crystalline self-assembled block copolymer aggregates: controlling release rates of ibuprofen

“…Again it is apparent that more detailed cryoTEM studies are required to fully ascertain the effect that ibuprofen inclusion has on the internal morphologies. Samples of P7-Ib, P5-IB and P6-IB dispersions (1 cm 3 ) were placed in a Quixsep dialyser sealed with a dialysis membrane and gently stirred in an excess of water (0.75 dm 3 ) over 6 hours at various temperatures (25,35,40 and 45 C).…”

“…Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) and there is considerable interest in the application of NSAIDs in cancer treatment with recent evidence suggesting such compounds reduce relapses and mortality rates. [24][25][26] …”