Abstract 868: Regular aspirin use and risk of multiple myeloma: A prospective analysis

Abstract

Abstract Multiple myeloma (MM) is a lethal malignancy with a poorly understood etiology and no prevention strategies. Aspirin inhibits nuclear factor (NF)-κB, a transcription factor that mediates growth factors important to MM pathogenesis. We undertook the present analysis to evaluate whether regular aspirin use is associated with MM risk and thus may offer opportunities for MM chemoprevention. We conducted prospective analyses of regular aspirin use and MM risk in the Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS) populations. Questions on regular aspirin use were first asked of women in 1980 and of men in 1986, and were updated thereafter on biennial follow-up questionnaires. Participants reported height and weight at enrollment (1976 in NHS, 1986 in HPFS), and updated weight biennially. We followed participants from the year of first aspirin use questions through the earliest among a cancer diagnosis, death, or June 2006 (NHS) or January 2006 (HPFS). We excluded persons with missing baseline exposure data or a baseline history of cancer. We imposed a 4-year lag on aspirin use classification to minimize the influence of preclinical MM-related bone pain on use; exposures were updated biennially. We identified 164 women and 110 men with MM during follow-up (i.e., 1,586,035 NHS and 593,489 HPFS person-years). We obtained hazard ratios (HR) and 95% confidence intervals (CI) from Cox proportional hazard models stratified by age and adjusted for body mass index, to assess the association of updated quantity and duration of aspirin use with MM. In men, cumulative average aspirin tablets/week (tab/wk) was inversely associated with MM risk. Compared to non-users, the HR (95% CI) was 0.60 (CI=0.36-0.98) for <3 tab/wk, 0.33 (0.12-0.92) for 3-<6 tab/wk, and 0.22 (0.03-1.56) for 6-<10 tab/wk. Duration of continuous aspirin use was also inversely associated with MM in men: compared to non-users, the HR (95% CI) was 0.62 (0.38-0.99) for ≤5 years, 0.54 (0.30-0.95) for 6-10 years, and 0.39 (0.12-1.25) for 11-20 years continuous use. Preliminary findings among women were suggestive of an inverse association of regular aspirin use with MM risk, but were not statistically significant. Analyses stratified by duration of use and BMI are ongoing. This prospective analysis offers evidence that regular aspirin use is associated with a diminished risk of MM. Thus, NF-κB dysregulation may contribute to MM etiology as well as to pathogenesis. However, the utility of aspirin for MM chemoprevention requires further clarification. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 868.