Abstract A116: Nonsteroidal anti-inflammatory drug use and risk of gastric and esophageal adenocarcinoma in a large cohort study

Abstract

Abstract A116 Background Previous studies suggest that the use of aspirin or non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the risk of gastric and esophageal adenocarcinomas, but few studies have been prospective, have used data collected directly from subjects, and have controlled for the many potential confounders. Methods: We examined the association between aspirin or non-aspirin NSAID use and incident gastric noncardia (N=182), gastric cardia (N=178), and esophageal adenocarcinomas (N=228) in the NIH-AARP Diet and Health prospective cohort study with subjects followed for up to 7 years. We estimated the hazard ratios (HR) and 95% confidence intervals (CI) in Cox models for any use of aspirin or non-aspirin NSAIDs in the previous twelve months or for the typical frequency of use (at least monthly, weekly, or daily) with adjustment for age, sex, smoking, alcohol, BMI, education, physical activity, and fruit and vegetable intake. Results For gastric noncardia cancer, we found that any aspirin use had an HR (95%CI) of 0.64 (0.47-0.86) and for daily use 0.57 (0.39-0.85). The age-standardized incidence rates (95% CI) per 100,000 person years dropped from 11.0 (8.4-13.6) in non-aspirin users to 7.0 (5.7-8.3) in users. For any non-aspirin NSAID use we found an HR (95%CI) of 0.68 (0.51-0.92) and for daily use 0.82 (0.50-1.34). We found no significant association between NSAID use and gastric cardia cancer or esophageal adenocarcinoma. For the latter, any or daily aspirin use had HR (95% CI) of 1.00 (0.73-1.37) and 1.11 (0.78-1.57), respectively. Conclusions We found a strong association between NSAID use, especially aspirin, and reduced risk of noncardia gastric adenocarcinoma, but not adenocarcinoma of the gastric cardia or esophagus. Citation Information: Cancer Prev Res 2008;1(7 Suppl):A116.