Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database.
OBJECTIVE
To examine whether anti-inflammatory drug treatment protects against the commoner cancers in the United Kingdom.


METHODS
Case-control study using the general practice research database.


METHODS
Practices throughout United Kingdom providing data to the database.


METHODS
Patients who had a first diagnosis of five gastrointestinal (oesophagus, stomach, colon, rectum, and pancreas) cancers and four non-gastrointestinal (bladder, breast, lung, and prostate) cancers in 1993-5 for whom prescription data were available for the at least the previous 36 months. Each case was matched for age, sex, and general practice with three controls.


METHODS
Risk of cancer.


RESULTS
In 12 174 cancer cases and 34 934 controls overall risk of the nine cancers was not significantly reduced among those who had received at least seven prescriptions in the 13-36 months before cancer diagnosis (odds ratio 0.98, 95% confidence interval 0.89 to 1.07). Findings were nevertheless compatible with protective effects from anti-inflammatory drugs against cancers of the oesophagus (0.64, 0. 41 to 0.98), stomach (0.51, 0.33 to 0.79), colon (0.76, 0.58 to 1. 00), and rectum (0.75, 0.49 to 1.14) with dose related trends. The risk of pancreatic cancer (1.49, 1.02 to 2.18) and prostatic cancer (1.33, 1.07 to1.64) was increased among patients who had received at least seven prescriptions, but the trend was dose related for only pancreatic cancer.


CONCLUSIONS
Anti-inflammatory drugs may protect against oesophageal and gastric cancer as well as colon and rectal cancer. The increased risks of pancreatic and prostatic cancer could be due to chance or to undetected biases and warrant further investigation.
Langman
M J
MJ
Department of Medicine University of Birmingham, Birmingham, B15 2TT. m.j.langman@bham.ac.uk
Cheng
K K
KK
Gilman
E A
EA
Lancashire
R J
RJ
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000517:prevention & control; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000517:prevention & control*; D006801:Humans; D008175:Lung Neoplasms / Q000517:prevention & control; D008297:Male; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000517:prevention & control; D011471:Prostatic Neoplasms / Q000517:prevention & control; D012306:Risk; D006113:United Kingdom; D001749:Urinary Bladder Neoplasms / Q000517:prevention & control
D000894:Anti-Inflammatory Agents, Non-Steroidal