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Aspirin and urologic cancer risk: an update

Nature Reviews Urology volume 9, pages 102–110 (2012)Cite this article

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Abstract

Aspirin has been associated with a reduced risk of colorectal cancer. With specific reference to urological cancers, a protective role for aspirin has been suggested for prostate cancer, but data for cancers of the bladder and kidney have been limited and inconsistent. Epidemiological evidence suggests that prostate cancer risk is reduced by 10% in regular aspirin users, with similar risk reductions reported in both case-control and cohort studies, and for both slow-growing and aggressive cancers. However, risk estimates were significantly heterogeneous and there was no relationship between risk reduction and frequency, dose or duration of use. Thus, inference for causality and public health implications remain far from conclusive. Although a few case-control studies have reported a favorable effect of aspirin on bladder cancer, most investigations did not find any meaningful association. A modest nonsignificant increased risk was reported for kidney cancer. Such excess risk, however, might be due to exposure to phenacetin-containing analgesics, which have been reported to increase renal cell cancer risk.

Key Points

  • Regular aspirin use is associated with a 10% reduced risk of prostate cancer

  • Overall, there is no relationship between frequency, dose or duration of aspirin use and prostate cancer risk

  • Regular aspirin use is unrelated to subsequent bladder cancer risk

  • The apparent excess risk of kidney cancer in relation to aspirin use might be due, at least in part, to misclassified exposure to phenacetin-containing analgesics

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Figure 1: Relative risk of prostate cancer for aspirin use versus never use.
Figure 2: Relative risk of bladder cancer for aspirin use versus never use.
Figure 3: Relative risk of kidney cancer for regular aspirin use versus never use.

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Acknowledgements

This work was conducted with the financial support of the Italian Association for Cancer Research. The authors thank Mrs I. Garimoldi for editorial assistance.

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Authors and Affiliations

  1. Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri”, Via La Masa 19, Milan, 20156, Italy

    Cristina Bosetti, Valentina Rosato & Silvano Gallus

  2. Department of Occupational Health, Università degli Studi di Milano, Via Vanzetti 5, Milan, 20113, Italy

    Carlo La Vecchia

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  1. Cristina Bosetti
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C. Bosetti wrote the article and contributed to researching the article, discussion of content, and editing the manuscript before submission. V. Rosato contributed to researching the article and editing the manuscript before submission. S. Gallus and C. La Vecchia contributed to the discussion of content and editing the manuscript before submission.

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Correspondence to Cristina Bosetti.

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Bosetti, C., Rosato, V., Gallus, S. et al. Aspirin and urologic cancer risk: an update. Nat Rev Urol 9, 102–110 (2012). https://doi.org/10.1038/nrurol.2011.219

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