title: Prospective evaluation of analgesic use and risk of renal cell cancer.
abstract: BACKGROUND
  Epidemiologic data suggest that analgesic use increases the risk of renal cell cancer (RCC), but few prospective studies have been published. We investigated the association between analgesic use and RCC in 2 large prospective studies.
  
  
  METHODS
  We examined the relationship between analgesic use and RCC risk in the Nurses' Health Study and the Health Professionals Follow-up Study. Use of aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen was ascertained in 1990 in the Nurses' Health Study and in 1986 in the Health Professionals Follow-up Study, and every 2 years thereafter. We evaluated baseline and duration of use of analgesics.
  
  
  RESULTS
  During follow-up of 16 years among 77,525 women and 20 years among 49,403 men, we documented 333 RCC cases. Aspirin and acetaminophen use were not associated with RCC risk. However, regular use of nonaspirin NSAIDs was associated with an increased RCC risk; the pooled multivariate relative risk was 1.51 (95% confidence interval, 1.12-2.04) at baseline. The absolute risk differences for users vs nonusers of nonaspirin NSAIDs were 9.15 per 100 000 person-years in women and 10.92 per 100,000 person-years in men. There was a dose-response relationship between duration of nonaspirin NSAID use and RCC risk; compared with nonregular use, the pooled multivariate relative risks were 0.81 (95% confidence interval, 0.59-1.11) for use less than 4 years, 1.36 (0.98-1.89) for 4 to less than 10 years, and 2.92 (1.71-5.01) for use for 10 or more years (P < .001 for trend).
  
  
  CONCLUSIONS
  Our prospective data suggest that longer duration of use of nonaspirin NSAIDs may increase the risk of RCC.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. eunyoung.cho@channing.harvard.edu
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Cho
authors.forename: Gary
authors.initials: G
authors.lastname: Curhan
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hankinson
authors.forename: Philip
authors.initials: P
authors.lastname: Kantoff
authors.forename: Michael B
authors.initials: MB
authors.lastname: Atkins
authors.forename: Meir
authors.initials: M
authors.lastname: Stampfer
authors.forename: Toni K
authors.initials: TK
authors.lastname: Choueiri
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012306:Risk
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen