Use of Nonsteroidal Antiinflammatory Drugs and Risk of Colon Cancer in a Population-based, Case-Control Study of African Americans and Whites

Abstract

African Americans have the highest colon cancer incidence and mortality rates among all US ethnic groups. Epidemiologic studies suggest that use of nonsteroidal antiinflammatory drugs (NSAIDs) is associated with a reduced risk of colon cancer, but no study to date with adequate sample size has reported on the association among African Americans. The authors examined the association between NSAID use and risk of colon cancer in a population-based, case-control study in North Carolina that enrolled 731 African-American (294 cases, 437 controls) and 960 White (349 cases, 611 controls) participants between 1996 and 2000. Odds ratios were calculated using unconditional logistic regression for categories of NSAIDs and colon cancer risk. Inverse associations between regular NSAID use and colon cancer were similar for African Americans (odds ratio = 0.41, 95% confidence interval: 0.22, 0.77) and Whites (odds ratio = 0.48, 95% confidence interval: 0.28, 0.83) but stronger for women than men. Inverse associations were slightly weaker for occasional versus regular NSAID use, but they were similar for aspirin and nonaspirin NSAID use. These results add new knowledge suggesting that the protective effect of NSAIDs against colon cancer is similar among African Americans and Whites.

Disparities in colorectal cancer in African-Americans vs Whites: Before and after diagnosis

“…High intake of beta carotene, vitamin C and calcium are associated with a lower risk of colorectal cancer in the white population whereas high intake of vitamin C and E are inversely associated with colorectal cancer risk in the African-American population [54] . Usage of non-steroidal anti-inflammatory drugs is associated with a reduced risk of colorectal cancer and this association did not vary among African Americans and Whites [55] . Fiber consumption is significantly associated with 50%-60% reduced risk of colorectal cancer in African Americans and non-significantly with 30% reduced risk of colorectal cancer in Whites [56] .…”

Aspirin and other non-steroidal anti-inflammatory drugs and risk of colorectal cancer: A Danish cohort study

“…In a secondary analysis of data from the Aspirin/ Folate Polyp Prevention Study, Kim et al examined risk of recurrent adenomas among subjects-randomized to either 81 mg aspirin or 325 mg aspirin daily versus placebowithin the WHO categories of BMI [5,27]. For advanced adenomas, the risk ratio of 325 mg aspirin compared with placebo was 1.23 (95% CI, 0.55-2.77) among normalweight subjects (BMI \ 25), 0.94 (95% CI, 0.54-1.64) among overweight (BMI [25][26][27][28][29], and 0.44 (95% CI, 0.17-1.10) among obese (BMI C 30). No clear pattern with BMI was observed for 81 mg aspirin or for adenoma overall.…”

“…Most observational epidemiological studies also point to a long latency for the effect of aspirin or non-aspirin NSAIDs (NA-NSAIDs) on CRC [16][17][18][19][20][21][22], but some studies have suggested that a protective effect may be achieved within a few years [23][24][25][26]. A recent post-trial analysis has suggested that the chemopreventive effect of NSAIDs on colorectal neoplasia may vary by body mass index (BMI) as marker for obesity [27]; however, the epidemiologic data on the influence of BMI are conflicting [19,21].…”

Aspirin and cancer risk: an updated quantitative review to 2005

“…Since this study did not provide risk estimates for users vs. nonusers, it was not included in the pooled estimates. A case-control study from North Carolina [27], including 294 African-American and 349 White colon cancer cases, gave a RR of 0.47 (95% CI: 0.27-0.80) for aspirin use, and similar risk estimates for use of any NSAIDs (RR = 0.49) and of non-aspirin NSAIDs only (RR = 0.46).…”