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1:
Breast Cancer Res.
2008;10(2):R38. Epub 2008 Apr 30.
Related Articles
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Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health-AARP Diet and Health Study.
Gierach GL
,
Lacey JV Jr
,
Schatzkin A
,
Leitzmann MF
,
Richesson D
,
Hollenbeck AR
,
Brinton LA
.
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, Suite 550, Rockville, MD 20852-7234, USA. gierachg@mail.nih.gov
INTRODUCTION: By inhibiting cyclooxygenase-2, nonsteroidal anti-inflammatory drugs (NSAIDs) decrease aromatase activity and might reduce breast cancer risk by suppressing estrogen synthesis. Epidemiologic evidence for a protective role of NSAIDs in breast cancer, however, is equivocal. METHODS: We tested NSAID use for its association with breast cancer incidence in the National Institutes of Health-AARP Diet and Health Study, where 127,383 female AARP (formerly known as the American Association of Retired Persons) members with no history of cancer, aged 51 to 72 years, completed a mailed questionnaire (1996 to 1997). We estimated relative risks of breast cancer for NSAID exposures using multivariate Cox proportional hazards regression models. The state cancer registry and mortality index linkage identified 4,501 primary incident breast cancers through 31 December 2003, including 1,439 estrogen receptor (ER)-positive cancers and 280 ER-negative cancers. RESULTS: Proportional hazards models revealed no statistically significant association between overall NSAIDs and total breast cancer. As cyclooxygenase inhibition by aspirin (but not other NSAIDs) is irreversible, we tested associations by NSAID type. Although we observed no significant differences in risk for daily use (versus nonuse) of aspirin (relative risk = 0.93, 95% confidence interval = 0.85 to 1.01) or nonaspirin NSAIDS (relative risk = 0.96, 95% confidence interval = 0.87 to 1.05), risk of ER-positive breast cancer was significantly reduced with daily aspirin use (relative risk = 0.84, 95% confidence interval = 0.71 to 0.98)--a relationship not observed for nonaspirin NSAIDS. Neither aspirin nor nonaspirin NSAIDs were associated with risk of ER-negative breast cancer. CONCLUSION: Breast cancer risk was not significantly associated with NSAID use, but daily aspirin use was associated with a modest reduction in ER-positive breast cancer. Our results provide support for further evaluating relationships by NSAID type and breast cancer subtype.
Publication Types:
Research Support, N.I.H., Intramural
MeSH Terms:
Aged
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
Anti-Inflammatory Agents, Non-Steroidal/pharmacology*
Aromatase Inhibitors/pharmacology
Aspirin/administration & dosage
Aspirin/pharmacology*
Breast Neoplasms/chemistry
Breast Neoplasms/epidemiology*
Breast Neoplasms/metabolism
Breast Neoplasms/pathology
Breast Neoplasms/prevention & control*
Cyclooxygenase 2/drug effects
Diet
Estrogens/biosynthesis*
Female
Health Behavior
Humans
Middle Aged
Multivariate Analysis
National Cancer Institute (U.S.)
National Institutes of Health (U.S.)
Neoplasm Staging
Proportional Hazards Models
Prospective Studies
Questionnaires
Receptors, Estrogen/analysis*
Registries
Risk Assessment
Risk Factors
United States/epidemiology
Substances:
Anti-Inflammatory Agents, Non-Steroidal
Aromatase Inhibitors
Estrogens
Receptors, Estrogen
Aspirin
Cyclooxygenase 2
PMID: 18447943 [PubMed - indexed for MEDLINE]
PMCID: PMC2397540
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