Editorial comment.

Abstract

Evidence from both observational (case-control or prospective cohort) studies and randomized clinical trials (primarily focused on vascular events) suggests that regular use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the risk of a number of epithelial cancers, including prostate cancer. The magnitude of the prostate cancer risk reduction associated with aspirin is modest, with pooled estimates from meta-analyses suggesting reductions on the order of 10%-20% compared to nonusers. 1 Algra A.M. Rothwell P.M. Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomized trials. Lancet Oncol. 2012; 13: 518-527 Abstract Full Text Full Text PDF PubMed Scopus (605) Google Scholar , 2 Bosetti C. Rosato V. Gallus S. et al. Aspirin and prostate cancer prevention. Recent Results Cancer Res. 2014; 202: 93-100 Crossref PubMed Scopus (11) Google Scholar , 3 Huang T.B. Yan Y. Guo Z.F. et al. Aspirin use and the risk of prostate cancer: a meta-analysis of 24 epidemiologic studies. Int Urol Nephrol. 2014; 46: 1715-1728 Crossref PubMed Scopus (40) Google Scholar A number of recent studies also suggest that aspirin or other NSAIDs are associated with a decrease in serum prostate-specific antigen (PSA) of approximately 10%. 4 Chang S.L. Harshman L.C. Presti Jr., J.C. Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey. J Clin Oncol. 2010; 28: 3951-3957 Crossref PubMed Scopus (97) Google Scholar , 5 Nieder C. Norum J. Geinitz H. Impact of common medications on serum total prostate-specific antigen levels and risk group assignment in patients with prostate cancer. Anticancer Res. 2011; 31: 1735-1740 PubMed Google Scholar , 6 Fowke J.H. Motley S.S. Smith Jr., J.A. et al. Association of nonsteroidal anti-inflammatory drugs, prostate specific antigen and prostate volume. J Urol. 2009; 181: 2064-2070 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar These results raise the question of whether aspirin OR NSAID use may lower PSA level to a degree that reduces the likelihood of being referred for biopsy. If true, this would be a significant clinical problem given that approximately 30% of men aged ≥50 years are reported to regularly use aspirin. 7 Brasky T.M. Velicer C.M. Kristal A.R. Nonsteroidal anti-inflammatory drugs and prostate cancer risk in the VITamins And Lifestyle (VITAL) Cohort. Cancer Epidemiol Biomarkers Prev. 2010; 19: 3185-3188 Crossref PubMed Scopus (29) Google Scholar The Impact of the Use of Aspirin and Other Nonsteroidal Anti-inflammatory Drugs on the Risk of Prostate Cancer Detection on BiopsyUrologyVol. 84Issue 5PreviewTo evaluate the association between nonsteroidal anti-inflammatory drug (NSAID) use and the risk of prostate cancer (PC) detection in men undergoing biopsy. Full-Text PDF ReplyUrologyVol. 84Issue 5PreviewWe would like to thank Dr. Bruce J. Trock for his insightful editorial and thoughtful commentary. Full-Text PDF