Analgesic and anti-inflammatory drug use and risk of bladder cancer: a population based case control study.
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.
Fortuny
Joan
J
Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Research (IMIM), 08003 Barcelona, Catalonia, Spain. jfortuny@imim.es
Kogevinas
Manolis
M
Zens
Michael S
MS
Schned
Alan
A
Andrew
Angeline S
AS
Heaney
John
J
Kelsey
Karl T
KT
Karagas
Margaret R
MR
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*
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
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