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Gynecol Oncol. 2013 Jan;128(1):113-119. doi: 10.1016/j.ygyno.2012.10.005. Epub 2012 Oct 9.

Non-steroidal anti-inflammatory drugs and endometrial cancer risk in the VITamins And Lifestyle (VITAL) cohort.

Author information

1
The Ohio State University College of Medicine, Department of Internal Medicine, Division of Cancer Prevention & Control, Columbus, OH, USA; Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, WA, USA. Electronic address: Theodore.Brasky@osumc.edu.
2
Roswell Park Cancer Institute, Division of Cancer Prevention and Population Sciences, Buffalo, NY, USA.
3
The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbus, OH, USA.
4
Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, WA, USA.

Abstract

OBJECTIVE:

Chronic inflammation may be an important factor in the initiation and promotion of endometrial cancer. Use of non-steroidal anti-inflammatory drugs (NSAIDs), however, has been inconsistently associated with endometrial cancer risk.

METHODS:

22,268 female residents of western Washington State, ages 50-76, completed a baseline questionnaire in 2000-2002 and reported on their use of individual NSAIDs over the past 10years. Use was categorized as none, low (<4days/week or <4years), and high (≥4days/week and ≥4years). Over 9years of follow-up, 262 incident invasive endometrial cancers were identified. Multivariable proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS:

Relative to non-use, high use of aspirin was inversely associated with endometrial cancer risk (HR 0.64, 95% CI: 0.41-1.01; P trend=0.03). Findings were stronger for regular-strength than low-dose aspirin. High use of non-aspirin NSAIDs (HR 1.15, 95% CI: 0.68-1.95), including ibuprofen (HR 1.29, 95% CI: 0.73-2.28), and naproxen (HR 1.08, 95% CI: 0.39-2.95) was not associated with risk. In subgroup analyses, findings for aspirin were strongest for cancers of endometrioid histology and were restricted to non-smokers.

CONCLUSIONS:

This study provides additional evidence that use of aspirin, but not non-aspirin NSAIDs, may reduce the risk of endometrial cancer, especially in estrogen-mediated cases; however additional prospective studies with high-quality measurement of NSAID use are needed. Aspirin should continue to be examined as a potential agent for cancer chemoprevention.

PMID:
23063765
PMCID:
PMC3534938
DOI:
10.1016/j.ygyno.2012.10.005
[Indexed for MEDLINE]
Free PMC Article

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