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Aspirin and Non-Aspirin NSAID Use and Prostate Cancer Incidence, Mortality, and Case Fatality in the Atherosclerosis Risk in Communities Study.

TitleAspirin and Non-Aspirin NSAID Use and Prostate Cancer Incidence, Mortality, and Case Fatality in the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsHurwitz LM, Joshu CE, Barber JR, Prizment AE, Vitolins MZ, Jones MR, Folsom AR, Han M
Secondary AuthorsPlatz EA
JournalCancer Epidemiol Biomarkers Prev
Volume28
Issue3
Pagination563-569
Date Published2019 03
ISSN1538-7755
KeywordsAnti-Inflammatory Agents, Non-Steroidal, Aspirin, Atherosclerosis, Ethnic Groups, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prognosis, Prospective Studies, Prostatic Neoplasms, Risk Assessment, Survival Rate, United States
Abstract

BACKGROUND: NSAIDs appear to moderately reduce prostate cancer risk. However, evidence is limited on whether NSAIDs protect against prostate cancer mortality (death from prostate cancer among men without a cancer history) and case fatality (death from prostate cancer among men with prostate cancer), and whether benefits are consistent in white and black men. This study investigated associations of aspirin and non-aspirin (NA) NSAID use with prostate cancer incidence, mortality, and case fatality in a population-based cohort of white and black men.

METHODS: We included 6,594 men (5,060 white and 1,534 black) from the Atherosclerosis Risk in Communities study without a cancer history at enrollment from 1987 to 1989. NSAID use was assessed at four study visits (1987-1998). Cancer outcomes were ascertained through 2012. Cox proportional hazards regression was used to estimate adjusted HRs, overall and by race.

RESULTS: Aspirin use was not associated with prostate cancer incidence. However, aspirin use was inversely associated with prostate cancer mortality [HR, 0.59; 95% confidence interval (CI), 0.36-0.96]. This association was consistent among white and black men and appeared restricted to men using aspirin daily and/or for cardiovascular disease prevention. Aspirin use was inversely associated with case fatality (HR, 0.45; 95% CI, 0.22-0.94). NA-NSAID use was not associated with these endpoints.

CONCLUSIONS: Aspirin use was inversely associated with prostate cancer mortality and case fatality among white and black men.

IMPACT: If confirmed by additional studies, benefits of aspirin for preventing prostate cancer mortality may need to be factored into risk-benefit calculations of men considering an aspirin regimen.

DOI10.1158/1055-9965.EPI-18-0965
Alternate JournalCancer Epidemiol Biomarkers Prev
PubMed ID30487131
PubMed Central IDPMC6401240
Grant ListU01 CA182883 / CA / NCI NIH HHS / United States
P30 CA006973 / CA / NCI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
U01 CA164975 / CA / NCI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
T32 CA009314 / CA / NCI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States