Abstract LB-286: Aspirin and nonsteroidal anti-inflammatory drug use and the risk of upper aerodigestive tract cancer

Abstract

Abstract Introduction: Aspirin and other NSAIDs are widely used as analgesic and preventative agents. Data on the chemopreventative role of these drugs on the risk of the upper aerodigestive tract (UADT) cancer are insufficient and mostly refer to oesophageal cancer. Aim: To investigate the effect of aspirin and other NSAIDs use on the risk of UADT cancers. Specific objectives were to investigate risk by cancer sub-site, duration of use and type of NSAIDs. Methods: A nested case-control study using the Primary Care Clinical Informatics Unit (PCCIU) database. Conditional logistic regression was used for data analysis. Results: There were 2,392 cases of UADT diagnosed between 1996 and 2010 and 7,165 age, gender and medical practice matched controls from 131 general medical practices. Mean age of cases was 66 years (SD 12), and most cases were males (63%). Aspirin was prescribed in a quarter of cases and controls, COX-2 inhibitors were prescribed in 4% of cases and 5% of controls and other NSAIDs were prescribed in 33% of cases and 36% of controls. Aspirin prescription was associated with non-significant reduced risk of cancer of UADT (OR 0.9 95% CI 0.8, 1.0), head and neck (HN) cancer (OR 0.9, 95% CI 0.7, 1.1) or the oesophagus (OR 0.8, 0.7, 1.0). Similar results were found for COX-2 prescription. Prescription of other NSAIDs was associated with significantly reduced risk of cancer of UADT (adjusted OR 0.8, 95% CI 0.7, 0.9), HN (adjusted OR 0.8, 95% CI 0.7, 0.9) and the oesophagus (OR 0.8, 0.7, 0.9). Significant risk reduction occurred with an increased number of aspirin prescriptions (OR 0.8, 95% CI 0.6, 0.9) for over 29 prescriptions compared to “never” aspirin prescription (test for trend P<0.001). Conclusion: There is evidence of a decreased risk of UADT cancer associated with ever being prescribed an NSAID (non-COX-2) as well as with increased number of aspirin prescriptions. Citation Format: Tatiana V. Macfarlane, Karen Lefevre, Margaret C. Watson. Aspirin and nonsteroidal anti-inflammatory drug use and the risk of upper aerodigestive tract cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-286. doi:10.1158/1538-7445.AM2014-LB-286