Non-Steroidal Anti-Inflammatory Drugs and Cancer Death in the Finnish Prostate Cancer Screening Trial.
Non-steroidal anti-inflammatory drugs (NSAIDs), especially aspirin, have been associated with lowered cancer incidence and mortality. We examined overall cancer mortality and mortality from specific cancer sites among the 80,144 men in the Finnish Prostate Cancer Screening Trial. Information on prescription drug use was acquired from the national drug reimbursement database. Over-the-counter use information was gathered by a questionnaire. Hazard ratios (HR) and 95% confidence intervals (CI) by prescription and over-the-counter NSAID use for overall and specific cancer deaths were calculated using Cox regression. During the median follow-up time of 15 years, 7,008 men died from cancer. Men with prescription NSAID use had elevated cancer mortality (HR 2.02 95% CI 1.91-2.15) compared to non-users. The mortality risk was increased for lung, colorectal and pancreas cancer mortality (HR 2.68, 95%CI 2.40-2.99, HR 1.91, 95% CI 1.57-2.32 and HR 1.93, 95% CI 1.58-2.37, respectively). The increased risk remained in competing risks regression (HR 1.11, 95% CI 1.05-1.18). When the usage during the last three years of follow-up was excluded, the effect was reversed (HR 0.69, 95% CI 0.65-0.73). Cancer mortality was not decreased for prescription or over-the-counter aspirin use. However, in the competing risk regression analysis combined prescription and over-the-counter aspirin use was associated with decreased overall cancer mortality (HR 0.76, 95% CI 0.70-0.82). Cancer mortality was increased for NSAID users. However, the risk disappeared when the last 3 years were excluded.
Department of Urology, Tampere University Hospital, Tampere, Finland.|School of Health Sciences, University of Tampere, Tampere, Finland.
Thea
T
Veitonmäki
Department of Urology, Tampere University Hospital, Tampere, Finland.|School of Medicine, University of Tampere, Tampere, Finland.
Teemu J
TJ
Murtola
Finnish Cancer Registry, Helsinki, Finland.
Kirsi
K
Talala
Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Kimmo
K
Taari
Department of Urology, Tampere University Hospital, Tampere, Finland.|School of Medicine, University of Tampere, Tampere, Finland.
Teuvo
T
Tammela
School of Health Sciences, University of Tampere, Tampere, Finland.
Anssi
A
Auvinen
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011467:Prostate / Q000187:drug effects / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin