Singer EA et al. (2008) Prostate-specific antigen levels in relation to consumption of nonsteroidal anti-inflammatory drugs and acetaminophen: results from the 2001–2002 National Health and Nutrition Examination Survey. Cancer [doi:10.1002/cncr.23806]

Inflammation has been implicated in the pathogenesis of prostate cancer; therefore, the use of NSAIDs and/or acetaminophen might decrease the risk of this malignancy. Singer et al. found that regular consumption of either of these agents lowers serum PSA levels, which indicate prostate injury and are believed to predict the risk of developing prostate cancer.

In this substudy of the US National Health and Nutrition Examination Study 2001–2002, the authors examined levels of total and free serum PSA in 1,319 men aged >40 years. Average PSA levels in current, regular (“nearly every day”) users of NSAIDs (19.8% of the study population) were 10% lower than those of patients who were not taking any of the drugs of interest (P = 0.038). Patients who regularly took acetaminophen (1.3% of the sample population) also had PSA levels consistently lower than the control participants who were not taking either of the study drugs. Conversely, individuals who took both NSAIDs and acetaminophen regularly (1.0% of the study population) had higher PSA levels than the control group, but this difference was not statistically significant.

Whether this decrease in PSA levels associated with regular NSAID or acetaminophen use indicates a protective effect of these agents against prostate cancer, or whether it does not affect the natural history of this disease at all and instead acts to mask pathological increases in PSA levels, is not known.