By Joene Hendry

NEW YORK (Reuters Health) - Use of a non-steroidal anti-inflammatory drug (NSAID) for over 5 years may lessen a person's risk of developing cancer of the lower portion of the large bowel, study findings suggest.

This risk reduction appears more robust among whites than among African Americans, Dr. Sangmi Kim, of the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, and colleagues found.

The investigators evaluated use of NSAIDs (i.e., aspirin, ibuprofen, and selective COX-2 inhibitors, taken to ease pain and inflammation) among 1,057 white and African American men and women with cancer of the lower bowel and rectum and 1,019 individuals who were cancer-free.

The participants with cancer included 790 whites and 267 African Americans, of whom 76 percent reported ever using NSAIDs during the 5 years prior to diagnosis. Of the cancer-free group, 83 percent reported NSAID use during the 5 years prior to study participation.

Compared with those never using NSAIDs, NSAID use was associated with about 40 percent reduced risk for cancer in the lower portion of the large bowel overall, after allowing for age, gender, race, body mass, physical activity, and other factors potentially associated with distal large bowel cancers.

In analyses that factored for race, the investigators found a "strongly protective" association between NSAIDs and large bowel cancer in whites, according to a report in the American Journal of Epidemiology.

"However," Kim told Reuters Health, "the risk reduction associated with NSAID use was less evident among African Americans."

Risk reduction was slightly stronger with prescription, rather than non-prescription NSAID use, but again this association was stronger among whites than among African Americans.

The apparent protective effect between NSAID use and cancer of the lower portion of the large bowel noted in this study is similar to that previously reported between NSAIDs and colon cancer.

Nonetheless, Kim and colleagues say more study is needed before recommending NSAIDs for the prevention of colorectal cancer in the general public.

SOURCE: American Journal of Epidemiology, December 1, 2008

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