Aspirin and non-aspirin NSAID use and prostate cancer incidence, mortality, and case fatality in the Atherosclerosis Risk in Communities study

Lauren M. Hurwitz, Corinne E. Joshu, John R. Barber, Anna E. Prizment, Mara Z. Vitolins, Miranda R. Jones, Aaron R. Folsom, Misop Han, Elizabeth A. Platz

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)563-569
Number of pages7
JournalCancer Epidemiology Biomarkers and Prevention
Volume28
Issue number3
DOIs
StatePublished - Mar 2019

Bibliographical note

Funding Information:
The authors thank the staff and participants of the ARIC study for their important contributions. Cancer incidence data have been provided by the Maryland Cancer Registry, Center for Cancer Surveillance and Control, Maryland Department The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute, NIH, and Department of Health and Human Services, under the following contract numbers: HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, and HHSN268201700002I. Studies on cancer in the ARIC are also supported by the NCI (U01 CA164975). This research was additionally supported by an NCI Cancer Center Support Grant (P30 CA006973). L.M. Hurwitz was supported by an NCI National Research Service Award (T32 CA09314).

Funding Information:
The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute, NIH, and Department of Health and Human Services, under the following contract numbers: HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, and HHSN268201700002I. Studies on cancer in the ARIC are also supported by the NCI (U01 CA164975). This research was additionally supported by an NCI Cancer Center Support Grant (P30

Funding Information:
of Health (Baltimore, MD). We acknowledge the State of Maryland, the Maryland Cigarette Restitution Fund, and the National Program of Cancer Registries of the Centers for Disease Control and Prevention for the funds that helped support the availability of the cancer registry data.

Publisher Copyright:
© 2018 American Association for Cancer Research.

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