title: Pre-diagnostic NSAID use but not hormone therapy is associated with improved colorectal cancer survival in women.
abstract: BACKGROUND
  Non-steroidal anti-inflammatory drugs (NSAIDs) and hormone therapy (HT) independently decrease the risk of colorectal cancer. However, their role in altering survival after a colorectal cancer diagnosis is not well established.
  
  
  METHODS
  We examined the association between the use of these common medications before diagnosis and colorectal cancer survival among women in western Washington State diagnosed with incident colorectal cancer from 1997 to 2002. Cases were ascertained using the Surveillance, Epidemiology and End Results cancer registry; mortality follow-up was completed through linkages to the National Death Index. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  We observed no overall association between colorectal cancer survival and pre-diagnostic NSAID use. However, when stratified by tumour sub-site, NSAID use was associated with a reduced risk of colorectal cancer mortality for women diagnosed with proximal (HR=0.55; 95% CI: 0.32-0.92), but not distal or rectal (HR=1.32; 95% CI: 0.83-2.10) tumours. The usage of HT was not associated with colorectal cancer survival overall or by tumour sub-site.
  
  
  CONCLUSIONS
  Usage of NSAIDs before diagnosis may be associated with improved colorectal cancer survival among women diagnosed with proximal tumours. The usage of HT does not appear to have a function in altering colorectal cancer mortality.
authors.affiliation: Fred Hutchinson Cancer Research Center, Cancer Prevention Program, 1100 Fairview Ave N, M4-B402, Seattle, WA 98109, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Coghill
authors.forename: P A
authors.initials: PA
authors.lastname: Newcomb
authors.forename: V M
authors.initials: VM
authors.lastname: Chia
authors.forename: Y
authors.initials: Y
authors.lastname: Zheng
authors.forename: K J
authors.initials: KJ
authors.lastname: Wernli
authors.forename: M N
authors.initials: MN
authors.lastname: Passarelli
authors.forename: J D
authors.initials: JD
authors.lastname: Potter
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012739:Gonadal Steroid Hormones