1237 THE IMPACT OF LONG-TERM NSAID USE ON INCIDENT UROTHELIAL CELL CARCINOMA IN THE VITAMINS AND LIFESTYLE STUDY

Abstract

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20111237 THE IMPACT OF LONG-TERM NSAID USE ON INCIDENT UROTHELIAL CELL CARCINOMA IN THE VITAMINS AND LIFESTYLE STUDY Cheryl Shih, Jonathan Wright, James Hotaling, Gaia Pocobelli, and Emily White Cheryl ShihCheryl Shih Seattle, WA More articles by this author , Jonathan WrightJonathan Wright Seattle, WA More articles by this author , James HotalingJames Hotaling Seattle, WA More articles by this author , Gaia PocobelliGaia Pocobelli Seattle, WA More articles by this author , and Emily WhiteEmily White Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.908AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Evidence suggests that use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lower the risk of several cancers. However, existing literature on the chemopreventive role of NSAIDs on urothelial cell carcinoma of the bladder (UC) is conflicting, limited by either retrospective study design or lack of data on known UC risk factors, such as smoking. Using the prospective VITamins And Lifestyle (VITAL) cohort study, we examine the association between NSAID use and the risk of UC. METHODS A cohort of 77,050 residents of Washington State aged 50–76 years completed a baseline questionnaire in 2000–2002 on NSAID use and cancer risk factors. The 10-year use of aspirin and other NSAIDs per week was calculated and categorized as none, low use (1–3 days/week or less than 4 years), and high use (greater or equal to 4 days/week for more than 4 years). The cohort was followed prospectively via linkage to the Surveillance, Epidemiology, and End Results (SEER) cancer registry to obtain incident UC cases. Hazard ratios (HR) were estimated by multivariate Cox regression models controlling for age, gender, smoking history, race, education, family history of UC, and conditions associated with NSAID use (chronic pain, arthritis, rheumatoid arthritis, headaches and cardiovascular disease). RESULTS With a median follow-up of 7 years, 385 incident cases of UC were diagnosed. In the full cohort, there was no association with aspirin, non-aspirin NSAID, or total NSAID use and risk of UC. However, among non-smokers and distant smokers (quit > 10 years ago), non-aspirin NSAID use was associated with a reduction in the risk of UC (p trend < 0.01). Compared to non-users, a reduction in risk was observed for both low (HR 0.72, 95% CI 0.51–1.01) and high (HR 0.51, 95% CI 0.27–0.97) users of non-aspirin NSAIDs. There was also a suggestion of reduction in UC risk among men, where an increased use of non-aspirin NSAIDs was associated with reduction in the risk of incident UC (p trend 0.08). No effect was observed in women. CONCLUSIONS In this prospective cohort study, a reduction in risk in UC was observed with non-aspirin NSAID use in certain populations, specifically among non-smokers, those with a distant history of smoking, and also among men. Whether NSAIDs can be used in the chemoprevention of UC will require further study. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e495 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cheryl Shih Seattle, WA More articles by this author Jonathan Wright Seattle, WA More articles by this author James Hotaling Seattle, WA More articles by this author Gaia Pocobelli Seattle, WA More articles by this author Emily White Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...