Regular Article

British Journal of Cancer (2001) 84, 1188–1192. doi:10.1054/bjoc.2000.1709 www.bjcancer.com
Published online 1 May 2001

Breast cancer and NSAID use: a meta-analysis

S A Khuder1 and A B Mutgi1

1Department of Medicine, Medical College of Ohio, 3120 Glendale Ave, Toledo, Ohio 43614-5809, USA

Received 19 October 2000; Revised 11 January 2001; Accepted 16 January 2001.

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Abstract

Recent epidemiological studies suggest that non-steroidal anti-inflammatory drugs (NSAIDs) reduce the risk of several cancers including breast cancer. This meta-analysis examined the studies on NSAID use and breast cancer. The estimators of relative risk and associated variances, which have been adjusted for the greatest number of confounders, were abstracted and included in the meta-analysis. Combined estimators of relative risk (RR) were calculated using either fixed or random effect models. Meta-analyses were performed on 6 cohort studies (number of cases ranged from 14 to 2414) and 8 case–control studies (number of cases ranged from 252 to 5882). The combined estimate of relative risk was 0.82 (95% confidence interval [CI] = 0.75–0.89). The combined estimate for cohort studies was 0.78 (95% CI = 0.62–0.99) and was 0.87 (95% CI = 0.84–0.91) for case–control studies. The findings of this meta-analysis suggest that NSAID use may be associated with a small decrease in the risk of breast cancer. However, the available data are insufficient to estimate the dose–response effect for duration and frequency of use of any particular types of NSAID. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords:

NSAID, breast cancer, meta-analysis, females

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References

  1. Baron JA (1995) Aspirin and cancer. Prev Med 24: 121–124 | Article | ChemPort |
  2. Bennett A, Berstock DA, Carroll MA, Stamford IF and Wilson AJ (1983) Breast cancer, its recurrence, and patient survival in relation to tumor prostaglandins. Samuelsson B, Paoletti R, Ramwell P (eds) Advances in prostaglandin, thromboxane, and leukotriene research Vol 12, Raven Press: New York
  3. Begg CB and Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50: 1088–1101 | Article | PubMed | ISI | ChemPort |
  4. Carter CA, Milholland RJ, Shea W and Ip MM (1983) Effect the prostaglandin synthetase inhibitor indomethacin on 7, 12-dimethylbenz(a)anthracene-induced mammary tumorigenesis in rats fed different levels of fat. Cancer Res 43: 3559–3562
  5. Cochran WG (1954) The combination of estimates from different experiments. Biometrics 8: 101–129
  6. Coogan FP, Rao RS, Rosenberg L, Palmer JR, Strom BL, Zauber AG, Stolley PD and Shapiro S (1999) The relationship of nonsteroidal anti-inflammatory drug use to the risk of breast cancer. Prev Med 29: 72–76 | Article | PubMed | ISI | ChemPort |
  7. Cotterchio M, Kreiger N, Steingart A and Buchan G (2000) Non-steroidal anti-inflammatory drugs (NSAID) use and breast cancer. SER Abstract. Am J Epidemiol 151: S72
  8. DerSimonian R and Laird N (1987) Meta-analysis in clinical trials. Controlled Clin Trials 7: 177–188
  9. Dinse GE, Umbach DM, Sasco AJ, Hoel DG and Davis DL (1999) Unexplained increases in cancer incidence in the United States from 1975 to 1994: possible sentinel health indicators? Ann Rev Public Health 20: 173–209
  10. Egan KM, Stampfer MJ, Giovannucci E, Rosner BA and Colditz GA (1996) Prospective study of regular aspirin use and the risk of breast cancer. J Natl Cancer Inst 88: 988–993 | Article | PubMed | ChemPort |
  11. Friedman GD and Ury HK (1980) Initial screening for carcinogenicity of commonly used drugs. J Natl Cancer Inst 65: 723–733 | PubMed | ChemPort |
  12. Gridley G, McLaughlin JK, Ekbom A, Klareskog L, Adami H, Hacker DG, Hoover R and Fraumeni, Jr JF (1993) Incidence of cancer among patients with rheumatoid arthritis. J Natl Cancer Inst 85: 307–311 | Article | PubMed | ChemPort |
  13. Harris RE, Namboodiri K, Stellman SD and Wynder EL (1995) Breast cancer and NSAID use: heterogeneity of effect in a case-control study. Prev Med 24: 119–120 | Article | PubMed | ISI | ChemPort |
  14. Harris RE, Namboodiri KK and Farrar WB (1996) Nonsteroidal antiinflammatory drugs and breast cancer. Epidemiology 7: 203–205 | PubMed | ISI | ChemPort |
  15. Harris RE, Kasbari S and Farrar WB (1999) Prospective study of nonsteroidal anti-inflammatory drugs and breast cancer. Oncol Rep 6: 71–73 | PubMed | ISI | ChemPort |
  16. Harris RE, Alshafie GA and Seibert K (2000) Chemoprevention of breast cancer in rats by celecoxib, a cyclooxygenase 2 inhibitor. Cancer Res 60: 2101–2103 | PubMed | ISI | ChemPort |
  17. Hwang D, Scollard D, Byrne J and Levine E (1998) Expression of cyclooxygenase-1 and cyclooxygenase-2 in human breast cancer. J Natl Cancer Inst 90: 455–460 | Article | PubMed | ChemPort |
  18. Kelsey JL, Gammon MD and John EM (1993) Reproductive factors and breast cancer. Epidemiol Rev 15: 36–47 | PubMed | ISI | ChemPort |
  19. Laakso M, Mutru O, Isomaki H and Koota K (1988) Cancer mortality in patients with rheumatoid arthritis. J Rheumatol 15: 1319–1322
  20. Lala PK, Al-mutter N and Orucevic A (1997) Effects of chronic indomethacin therapy on the development and progressions of spontaneous mammary tumors in C3H/HEJ mice. Int J Cancer 73: 371–380 | Article | PubMed | ISI | ChemPort |
  21. Langman MJS, Cheng KK, Gilman EA and Lancashire RJ (2000) Effect of anti-inflammatory drugs on the overall risk of common cancer: case-control study in general practice research database. Br Med J 320: 1642–1646 | Article | ChemPort |
  22. Lupulescu A (1978) Enhancement of carcinogenesis by prostaglandins. Nature 272: 634–636 | Article | PubMed | ISI | ChemPort |
  23. Lynch NR, Castes M, Astoin M and Salomon JC (1978) Mechanism of inhibition of tumour growth by aspirin and indomethacin. Br J Cancer 38: 503–512 | PubMed |
  24. Madigan MP, Ziegler RG, Benichou J, Byrne C and Hoover RN (1995) Proportion of breast cancer cases in the United States explained by well-established risk factors. J Natl Cancer Inst 87: 1681–1685 | Article | PubMed | ChemPort |
  25. McCormick DI and Wilson AM (1986) Combination chemoprevention of rat mammary carcinogenesis by indomethacin. Cancer Res 46: 3907–3911
  26. Mellemkjaer L, Linet MS, Gridley G, Frisch M, Moller H and Olsen JH (1996) Rheumatoid arthritis and cancer risk. Eur J Cancer 32A: 1753–1757
  27. Neugut AI, Rosenberg DJ, Ahsan H, Jacobson JS, Wahid N, Hagan M, Rahman MI, Khan ZR, Chen L, Pablos-Mendez A and Shea S (1998) Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomarker Prev 7: 869–873
  28. Paganini-Hill A, Chao A, Ross RK and Henderson BE (1989) Aspirin use and chronic diseases: a cohort study of the elderly. Br Med J 299: 1247–1250 | ChemPort |
  29. Robertson FM, Parett ML, Jorder FS, Ross M, Abo-IssaAlshafie G and Harris RE (1998) Ibuprofen-induced inhibition of cyclooxygenase isoform gene expression and regression of rat mammary carcinoma. Cancer Lett 122: 165–175 | Article | PubMed | ISI | ChemPort |
  30. Rosenberg L (1995) Nonsteroidal anti-inflammatory drugs and cancer. Prev Med 24: 107–109 | Article | PubMed | ISI | ChemPort |
  31. Rosenberg L, Palmer JR, Zauber AG, Warshauer ME, Stolley PD and Shapiro S (1991) A hypothesis: nonsteroidal anti-inflammatory drugs reduce the incidence of large-bowel cancer. J Natl Cancer Inst 83: 355–358 | Article | PubMed | ChemPort |
  32. Schreinemachers DM and Everson RB (1994) Aspirin use and lung, colon, and breast cancer incidence in a prospective study. Epidemiology 5: 138–146 | Article | PubMed | ISI | ChemPort |
  33. Sharpe CR, Collet JP, McNutt M, Belzille E, Boivin JF and Hanley JA (2000) Nested case-control study of the effects of non-steroidal anti-inflammatory drugs on breast cancer risk and stage. Br J Cancer 83: 112–120 | Article | PubMed | ISI | ChemPort |
  34. Thompson HJ, Briggs S, Paranka NS, Piazza GA, Brendel K, Gross PH, Sperl GJ, Pamukcu R and Ahnen DJ (1995) Inhibition of mammary carcinogenesis in rats by sulfone metabolite of sulindac. J Natl Cancer Inst 87: 1259–1260 | PubMed | ChemPort |
  35. Thun MJ, Namboodri MM, Calle EE, Flanders WD and Heath CW (1993) Aspirin use and risk of fetal cancer. Cancer Res 53: 1322–1327 | PubMed | ISI | ChemPort |
  36. Van Aswegen C, van Schalkwyk ICD, Roux LJ, Becker PJ and Du Plessis DJ (1992) A novel study on the effect of acetylsalicylic acid on the binding capacity of estrogen receptors from MCF-7 cells. Clin Physiol Biochem 9: 145–149
  37. Wun LM, Feuer EJ and Miller BA (1995) Are increases in mammographic screening still a valid explanation for trend in breast cancer incidence in the United States?. Cancer Cause Control 6: 135–144