title: Aspirin and other nonsteroidal anti-inflammatory drugs and breast cancer incidence in a large U.S. cohort.
abstract: Use of nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, has consistently been associated with reduced risk of breast cancer in case-control studies. However, results from prospective studies have been less consistent. We examined the association between NSAID use and breast cancer incidence, adjusting for multiple breast cancer risk factors among 77,413 women in the Cancer Prevention Study II Nutrition Cohort. During follow-up from 1992 to 2001, we observed 3,008 cases of incident breast cancer. Information on NSAID use was obtained from a questionnaire completed at enrollment in 1992 or 1993 and was updated using follow-up questionnaires in 1997 and 1999. NSAID use was modeled using time-dependent variables to update exposure status. Neither current total NSAID use (aspirin and other NSAIDs combined) nor current aspirin use were associated with breast cancer incidence even at relatively high levels of use [rate ratio (RR), 1.07; 95% confidence interval (95% CI), 0.96-1.21 for > or =60 NSAID pills per month compared with no reported use of NSAIDs; RR, 1.01; 95% CI, 0.84-1.20 for > or =60 aspirin per month compared with no reported use of aspirin]. Even long-duration regular use (> or =30 pills per month for > or =5 years) was not associated with breast cancer incidence (RR, 1.05; 95% CI, 0.88-1.26 for total NSAIDs; RR, 0.88; 95% CI, 0.69-1.12 for aspirin). Although we cannot exclude a small reduction in breast cancer risk associated with NSAID use, the results of this study provide evidence against a large reduction in risk.
authors.affiliation: Department of Epidemiology and Surveillance Research, American Cancer Society, National Home Office, 1599 Clifton Road Northeast, Atlanta, GA 30329-4251, USA. Eric.Jacobs@cancer.org
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Jacobs
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thun
authors.forename: Cari J
authors.initials: CJ
authors.lastname: Connell
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodriguez
authors.forename: S Jane
authors.initials: SJ
authors.lastname: Henley
authors.forename: Heather S
authors.initials: HS
authors.lastname: Feigelson
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
authors.forename: W Dana
authors.initials: WD
authors.lastname: Flanders
authors.forename: Eugenia E
authors.initials: EE
authors.lastname: Calle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin