title: Regular analgesic use and risk of multiple myeloma.
abstract: Analgesic use has been implicated in the chemoprevention of a number of solid tumors, but to date no previous research has focused on the role of analgesics in the etiology of multiple myeloma (MM). We conducted a hospital-based case-control study of 117 patients with primary, incident MM and 483 age and residence matched controls without benign or malignant neoplasms. All participants received medical services at Roswell Park Cancer Institute in Buffalo, NY, and completed a comprehensive epidemiological questionnaire. Participants who reported analgesic use at least once a week for at least 6 months were classified as regular users; individuals who did not use analgesics regularly served as the reference group throughout the analyses. We used unconditional logistic regression analyses to compute crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Compared to non-users, regular aspirin users were not at reduced risk of MM (adjusted OR=0.99; 95% CI 0.65-1.49), nor were participants with the highest frequency or duration of aspirin use. A significant risk elevation was found for participants who were regular acetaminophen users (adjusted OR=2.95; 95% CI 1.72-5.08). Further, marked increases in risk of MM were noted with both greater frequency (>7 tablets weekly; adjusted OR=4.36; 95% CI 1.70-11.2) and greater duration (>10 years; adjusted OR=3.26; 95% CI 1.52-7.02) of acetaminophen use. We observed no evidence of a chemoprotective effect of aspirin on MM risk, but observed significant risk elevations with various measures of acetaminophen use. Our results warrant further investigation in population-based case-control and cohort studies and should be interpreted with caution in light of the limited sample size and biases inherent in hospital-based studies.
authors.affiliation: Department of Epidemiology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States. kristen.moysich@roswellpark.org
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Moysich
authors.forename: Mathew R
authors.initials: MR
authors.lastname: Bonner
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Beehler
authors.forename: James R
authors.initials: JR
authors.lastname: Marshall
authors.forename: Ravi J
authors.initials: RJ
authors.lastname: Menezes
authors.forename: Julie A
authors.initials: JA
authors.lastname: Baker
authors.forename: Joli R
authors.initials: JR
authors.lastname: Weiss
authors.forename: Asher
authors.initials: A
authors.lastname: Chanan-Khan
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000700:Analgesics / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D016022:Case-Control Studies; D015331:Cohort Studies; D003710:Demography; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D001241:Aspirin