title: Analgesic and anti-inflammatory drug use and risk of bladder cancer: a population based case control study.
abstract: BACKGROUND
  Use of phenacetin and other analgesic and non-steroidal anti-inflammatory drugs (NSAIDs) potentially influences bladder cancer incidence, but epidemiologic evidence is limited.
  
  
  METHODS
  We analyzed data from 376 incident bladder cancer cases and 463 controls from a population-based case-control study in New Hampshire on whom regular use of analgesic drugs and NSAIDs was obtained. Odds ratios and 95% confidence intervals were computed using logistic regression with adjustment for potentially confounding factors. Separate models by tumor stage, grade and TP53 status were conducted.
  
  
  RESULTS
  We found an elevated odds ratio (OR) associated with reported use of phenacetin-containing medications, especially with longer duration of use (OR >8 years = 3.00, 95% confidence interval (CI) = 1.4-6.5). In contrast, use of paracetamol did not relate overall to risk of bladder cancer. We also found that regular use of any NSAID was associated with a statistically significant decrease in bladder cancer risk (OR = 0.6, 95% CI = 0.4-0.9), and specifically use of aspirin. Further, the association with NSAID use was largely among invasive, high grade and TP53 positive tumors.
  
  
  CONCLUSIONS
  While these agents have been investigated in several studies, a number of questions remain regarding the effects of analgesic and NSAID use on risk of bladder cancer.
authors: Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Research (IMIM), 08003 Barcelona, Catalonia, Spain. jfortuny@imim.es
authors: Joan
authors: J
authors: Fortuny
authors: Manolis
authors: M
authors: Kogevinas
authors: Michael S
authors: MS
authors: Zens
authors: Alan
authors: A
authors: Schned
authors: Angeline S
authors: AS
authors: Andrew
authors: John
authors: J
authors: Heaney
authors: Karl T
authors: KT
authors: Kelsey
authors: Margaret R
authors: MR
authors: Karagas
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
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