title: Aspirin and NSAID use and lung cancer risk: a pooled analysis in the International Lung Cancer Consortium (ILCCO).
abstract: OBJECTIVE
  To investigate the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) lower lung cancer risk.
  
  
  METHODS
  We analysed pooled individual-level data from seven case-control and one cohort study in the International Lung Cancer Consortium (ILCCO). Relative risks for lung cancer associated with self-reported history of aspirin and other NSAID use were estimated within individual studies using logistic regression or proportional hazards models, adjusted for packyears of smoking, age, calendar period, ethnicity and education and were combined using random effects meta-analysis.
  
  
  RESULTS
  A total of 4,309 lung cancer cases (mean age at diagnosis 65 years, 45% adenocarcinoma and 22% squamous-cell carcinoma) and 58,301 non-cases/controls were included. Amongst controls, 34% had used NSAIDs in the past (81% of them used aspirin). After adjustment for negative confounding by smoking, ever-NSAID use (affirmative answer to the study-specific question on NSAID use) was associated with a 26% reduction (95% confidence interval 8 to 41%) in lung cancer risk in men, but not in women (3% increase (-11% to 30%)). In men, the association was stronger in current and former smokers, and for squamous-cell carcinoma than for adenocarcinomas, but there was no trend with duration of use. No differences were found in the effects on lung cancer risk of aspirin and non-aspirin NSAIDs.
  
  
  CONCLUSIONS
  Evidence from ILCCO suggests that NSAID use in men confers a modest protection for lung cancer, especially amongst ever-smokers. Additional investigation is needed regarding the possible effects of age, duration, dose and type of NSAID and whether effect modification by smoking status or sex exists.
authors: Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon, France. mccormackv@iarc.fr
authors: Valerie A
authors: VA
authors: McCormack
authors: Rayjean J
authors: RJ
authors: Hung
authors: Darren R
authors: DR
authors: Brenner
authors: Heike
authors: H
authors: Bickeböller
authors: Albert
authors: A
authors: Rosenberger
authors: Joshua E
authors: JE
authors: Muscat
authors: Philip
authors: P
authors: Lazarus
authors: Anne
authors: A
authors: Tjønneland
authors: Søren
authors: S
authors: Friis
authors: David C
authors: DC
authors: Christiani
authors: Eun-Mi
authors: EM
authors: Chun
authors: Loic
authors: L
authors: Le Marchand
authors: Gad
authors: G
authors: Rennert
authors: Hedy S
authors: HS
authors: Rennert
authors: Angeline S
authors: AS
authors: Andrew
authors: Irene
authors: I
authors: Orlow
authors: Bernard
authors: B
authors: Park
authors: Paolo
authors: P
authors: Boffetta
authors: Eric J
authors: EJ
authors: Duell
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001241:Aspirin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin