title: Association of nonsteroidal anti-inflammatory drugs and aspirin use and the risk of head and neck cancers: a meta-analysis of observational studies.
abstract: OBJECTIVE
  Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, have emerged as the potential chemopreventive agents for a number of cancer types, however, previous studies of head and neck cancers (HNC) have yielded inconclusive results. We performed a meta-analysis of observational studies to quantitatively assess the association between NSAIDs use and the risk for HNC.
  
  
  METHODS
  We searched Pubmed, Embase, Google scholar, and Cochrane library for relevant studies that were published in any language, from January 1980 to April 2016. We pooled the odds ratio (OR) from individual studies and performed subgroup, heterogeneity, and publication bias analyses.
  
  
  RESULTS
  A total of eleven studies (eight case-control studies and three cohort studies), involving 370,000 participants and 10,673 HNC cases contributed to this meta-analysis. The results of these studies suggested that neither use of overall NSAIDs (OR=0.95; 95% CI, 0.81-1.11), aspirin (OR=0.93; 95% CI, 0.79-1.10), nor nonsteroidal NSAIDs (OR=0.92; 95% CI, 0.76-1.10) were associated with HNC risk. Similar nonsteroidal results were observed when stratified by HNC sites, study design, sample size, and varied adjustment factors. However, we found significant protective effect of ibuprofen (OR=0.85; 95% CI, 0.72-0.99) and long-term aspirin use (≧5years) (OR=0.75; 95% CI, 0.65-0.85) on HNC risk, with low heterogeneity and publication bias.
  
  
  CONCLUSIONS
  Our meta-analysis results do not support the hypothesis that overall use of NSAIDs significant reduces the risk of HNC. Whereas, we cannot rule out a modest reduction in HNC risk associated with ibuprofen and long-term aspirin use.
authors.affiliation: Department of Oncology, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Lanhua
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Huabin
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Radiotherapy, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.|Key Laboratory of Translational Radiation Oncology, Changsha, China.
authors.forename: Huai
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Chengzhu
authors.initials: C
authors.lastname: Jian
authors.affiliation: Department of Radiotherapy, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.|Key Laboratory of Translational Radiation Oncology, Changsha, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Oncology, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D064887:Observational Studies as Topic; D016017:Odds Ratio
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin; D007052:Ibuprofen
keywords: aspirin; chemoprevention; head and neck cancer; meta-analysis; nonsteroidal anti-inflammatory drugs