title: Non-steroidal anti-inflammatory drugs and cancer risk in women: results from the Women's Health Initiative.
abstract: The use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risks of cancers at several sites in some studies; however, we recently reported no association between their use and total cancer risk in women in a prospective study. Here we examine the association between NSAIDs and total and site-specific cancer incidence in the large, prospective Women's Health Initiative (WHI). Women (129,013) were recruited to participate in the WHI at 40 US clinical centers from 1993 to 1998 and followed prospectively. After 9.7 years of follow-up, 12,998 incident, first primary, invasive cancers were diagnosed. NSAID use was systematically collected at study visits. We used Cox proportional hazards regression models to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations between NSAIDs use and total and site-specific cancer risk. Relative to non-use, consistent use (i.e., use at baseline and year 3 of follow-up) of any NSAID was not associated with total cancer risk (HR 1.00, 95% CI: 0.94-1.06). Results for individual NSAIDs were similar to the aggregate measure. In site-specific analyses, NSAIDs were associated with reduced risks of colorectal cancer, ovarian cancer, and melanoma. Our study confirms a chemopreventive benefit for colorectal cancer in women and gives preliminary evidence for a reduction of the risk of some rarer cancers. NSAIDs' benefit on cancer risk was therefore limited to specific sites and not evident when total cancer risk was examined. This information may be of importance when NSAIDs are considered as chemopreventive agents.
authors.affiliation: Department of Internal Medicine Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, OH; Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Brasky
authors.forename: Jingmin
authors.initials: J
authors.lastname: Liu
authors.forename: Emily
authors.initials: E
authors.lastname: White
authors.forename: Ulrike
authors.initials: U
authors.lastname: Peters
authors.forename: John D
authors.initials: JD
authors.lastname: Potter
authors.forename: Roland B
authors.initials: RB
authors.lastname: Walter
authors.forename: Christina S
authors.initials: CS
authors.lastname: Baik
authors.forename: Dorothy S
authors.initials: DS
authors.lastname: Lane
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
authors.forename: Jean Y
authors.initials: JY
authors.lastname: Tang
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D016588:Anticarcinogenic Agents / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D015994:Incidence; D008875:Middle Aged; D009288:Naproxen / Q000008:administration & dosage*; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D017698:Postmenopause; D011446:Prospective Studies; D012306:Risk
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016588:Anticarcinogenic Agents; D009288:Naproxen; D001241:Aspirin; D007052:Ibuprofen
keywords: aspirin; cancer; ibuprofen; inflammation; naproxen; non-steroidal anti-inflammatory drug