Patterns of acute inflammatory symptoms prior to cancer diagnosis

Andrea Setiawan,Gert Auer,Yudi Pawitan,Li Yin,Karin E Smedby,Kamila Czene

doi:10.1038/s41598-017-00133-8

Andrea Setiawan, Gert Auer + Show 4 more

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https://doi.org/10.1038/s41598-017-00133-8

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Abstract

Although many studies have examined the role of chronic inflammation in cancer development, few studies discuss the patterns of acute inflammation prior to cancer diagnosis. Patients with lung, colorectal, prostate, or breast cancer between 1 July 2006 and 31 December 2009 and their metastatic status at diagnosis were determined through the Swedish Cancer Register. Non-steroidal anti-inflammatory drugs (NSAIDs) use in the year prior to cancer diagnosis was assessed through the Swedish Prescribed Drug Register. There were 13,945 patients identified with breast cancer, 6501 with prostate cancer, 5508 with lung cancer, and 12,723 with colon cancer. For metastatic patients, there is strong evidence of higher NSAIDs use 1–3 months compared to 10–12 months prior to diagnosis (breast odds ratio (OR) = 3.54, 95% CI 2.26–5.54; prostate OR = 3.90, 95% CI 3.10–4.90; lung OR = 2.90 95% CI 2.44–3.44; colorectal OR = 1.67, 95% CI 1.36–2.05). For non-metastatic patients, increased NSAIDs use 1–3 months prior to diagnosis was also observed, but only to a smaller extent for lung and prostate cancer (prostate OR = 1.48, 95% CI 1.27–1.72; lung 1.41, 95% CI 1.19–1.67). In conclusion, if NSAIDs use reflects underlying inflammatory symptoms, there is support for the hypothesis that advanced cancer was associated with an acute inflammatory process.

Highlights

Many studies have examined the role of chronic inflammation in cancer development, few studies discuss the patterns of acute inflammation prior to cancer diagnosis
Ott et al.[8] notes that most cancers are initially asymptomatic, so without an early screening program they may get diagnosed at an advanced stage, such as in lung cancer patients, we aim to investigate the hypothesis that acute and nonspecific inflammatory symptoms emerge when cancer is at advance stage
Colorectal cancer patients showed lower increase. (ii) For non-metastatic patients, there was an increase of drug use, but only to a smaller extent for lung and prostate cancer patients. (iii) None of these increases was observed in the control group or with the use of statin and metformin, indicating that the phenomenon was specific to the use Non-steroidal anti-inflammatory drugs (NSAIDs) prior to cancer diagnosis. (iv) For non-metastatic patients, we did not observe any association between drug use within 6 months prior to diagnosis and overall survival after diagnosis

Summary

Introduction

Many studies have examined the role of chronic inflammation in cancer development, few studies discuss the patterns of acute inflammation prior to cancer diagnosis. Non-steroidal anti-inflammatory drugs (NSAIDs) use in the year prior to cancer diagnosis was assessed through the Swedish Prescribed Drug Register. There is strong evidence of higher NSAIDs use [1,2,3] months compared to [10,11,12] months prior to diagnosis (breast odds ratio (OR) = 3.54, 95% CI 2.26–5.54; prostate OR = 3.90, 95% CI 3.10–4.90; lung OR = 2.90 95% CI 2.44–3.44; colorectal OR = 1.67, 95% CI 1.36–2.05). If NSAIDs use reflects underlying inflammatory symptoms, there is support for the hypothesis that advanced cancer was associated with an acute inflammatory process. We study the patterns of anti-inflammatory use in the year prior to cancer diagnosis to reveal when and to what extent inflammatory symptoms emerge in patients who will be diagnosed with an advanced stage of cancer

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