Selective COX2 inhibitors, other NSAIDS, and influence of COX2 polymorphisms on breast cancer risk: Results from the CECILE study

Abstract

Background In the context of a possible role of chronic inflammation in cancer risk, our objective was to investigate breast cancer risk in relation to the use of selective COX2 inhibitors and other non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin, and to explore interactions of NSAIDs with COX2 genetic polymorphisms. Methods We conducted a population-based case-control study in France on breast cancer risk factors. Data on NSAID use were obtained in 871 cases and 915 controls using a standardized questionnaire, and 7 single nucleotide polymorphisms in the COX2 gene were genotyped in 811 cases and 829 controls. Odds ratios (OR) and their 95% confidence intervals (CI) were calculated using unconditional logistic regression models. Results We found an inverse association between breast cancer and NSAID use (OR = 0.80, 95% CI: 0.66–0.97), which was stronger for COX2 selective inhibitors (OR = 0.55, 95% CI: 0.35–0.86). Associations were more pronounced in salicylate non-users and overweight women. The SNP rs5275 in COX2 genes was associated with breast cancer (P = 0.01) and a significant interaction between rs5275 and NSAID use was observed (P for interaction 0.02). Conclusion Our results confirm an inverse association between NSAID use and breast cancer and highlight the role of selective COX2 inhibitors. Polymorphisms of the COX2 gene may modify the risk of breast cancer associated with NSAID use.