Aspirin, non-steroidal anti-inflammatory drug and paracetamol use is associated with an increased risk of prostate cancer in a large, population-based, case-control study


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Ali Murad1, Liz Down1, George Davey Smith1, Jenny Donovan1, Janet Athene Lane1, Freddie Hamdy2, David Neal3, Richard Martin1

1University of Bristol, UK, 2John Radcliffe Hospital, Oxford, UK, 3University of Cambridge, UK

Abstract

Background
Evidence from laboratory studies suggests that chronic inflammation plays an important role in prostate cancer aetiology. This has resulted in speculation that non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen, may protect against prostate cancer development.

Method
We used data from a case-control study (ncases= 1,016; ncontrols= 5,043), nested within a UK-wide population-based study that used a PSA-testing approach, to investigate the effect of aspirin, non-steroidal anti-inflammatory drug and paracetamol use on prostate cancer risk.

Results
We found evidence for an increased risk of PSA-detected prostate cancer amongst users of aspirin (OR= 1.24, 95% CI= 1.01 to 1.52), non-aspirin non-steroidal anti-inflammatory drugs (OR= 1.51, 95% CI= 1.13 to 2.01) and overall non-steroidal anti-inflammatory drugs (OR= 1.37, 95% CI= 1.14 to 1.64). Paracetamol use was not associated with prostate cancer. Aspirin, non-steroidal anti-inflammatory drug and paracetamol use were associated with reduced serum PSA concentrations amongst controls.

Conclusion
Our findings raise doubts about the suitability and safety of using non-steroidal anti-inflammatory drugs as chemopreventive agents in the primary prevention of prostate cancer.

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