Nonsteroidal anti-inflammatory drugs and risk of lung cancer.
Int. J. Cancer 2007; 120:1565–1572.
ABSTRACT
Regular aspirin and non-aspirin nonsteroidal anti-inflammatory drug
(NSAID) use is associated with a reduced risk of colorectal cancer. The
effect of NSAIDs on the risk of other cancers remains unclear. To
evaluate whether use of aspirin or other specific NSAIDs protects
against lung cancer, we conducted a case–control study nested in a
cohort of subjects 40–84 years old in 1995–2004, without a diagnosis of
cancer before the study start date, and with at least 2 years of
enrollment with a general practitioner providing data to the The Health
Improvement Network (THIN) database in the UK. Patients who had a first
diagnosis of primary lung cancer during the study period were considered
cases. A random sample of 10,000 controls was frequency-matched to the
cases for age, sex and calendar year. The index date for exposure
definition was 1 year before the date of diagnosis for cases and 1 year
before a random date within the study period for controls. Relative
risks and 95% confidence intervals were estimated using conditional
logistic regression stratified for matching factors. Factors such as
smoking, chronic obstructive pulmonary disease, cardiovascular diseases
and body mass index were introduced in the model. We identified 4,336
cases with primary incident lung cancer (incidence rate 7.6 per 10,000
person-years). Compared with subjects with no prescription of
non-aspirin NSAID prior to the index date, the risk of lung cancer was
0.76 (0.61–0.94) among those who received a prescription the previous
year and had a treatment duration of at least 1 year. The corresponding
relative risk was 1.15 (0.99– 1.34) for aspirin. In conclusion,
prescription of non-aspirin NSAIDs for at least 1 year might be
associated with a slightly reduced risk of lung cancer. Aspirin was not
associated with a risk reduction, perhaps due to residual confounding