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Nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer.
Cancer Epidemiol Biomarkers Prev. 2005 Feb; 14(2):444-50.CE

Abstract

INTRODUCTION

Nonsteroidal anti-inflammatory drugs (NSAID) might reduce risks of esophageal and gastric cancer, but previous studies are limited and provide somewhat conflicting results.

METHODS

We tested these associations in a prospective, nested case-control study based on the General Practitioners Research Database, including over 2 million persons in the United Kingdom between 1994 and 2001. In multivariate analyses we calculated odds ratios (OR) with 95% confidence intervals (95% CI). Data were stratified by history of upper gastrointestinal (UGI) disorders and recalculated using 2 years lag time on data (i.e., excluding all information 2 years before index date).

RESULTS

Among 4,340,207 person-years of follow-up, we identified 909 patients with esophageal cancer and 1,023 patients with gastric cancer. We randomly selected 10,000 control subjects. Overall analysis suggested that long-term users of nonaspirin NSAIDs were at reduced risks of esophageal (OR, 0.82; 95% CI, 0.57-1.18) and gastric cancer (OR, 0.65; 95% CI, 0.44-0.94), whereas long-term aspirin users might be at decreased risk of esophageal cancer (OR, 0.76; 95% CI, 0.53-1.08), but not of gastric cancer (OR, 1.09; 95% CI, 0.82-1.45). All estimates of reduced risk were weakened in the 2 years lag time analysis except the association between nonaspirin NSAIDs long-term users and gastric cancer. Potentially protective effects were suggestive of being more marked among subjects with a history of UGI disorders.

CONCLUSIONS

Nonaspirin NSAIDs long-term use was associated with a reduced risk of gastric cancer, whereas no other studied associations could be firmly established. Our results suggest that UGI disorders could distort the associations, although we could not show this with statistical significance. If such bias was to be true, the previously reported inverse associations might, at least partly, be explained by lack of appropriate adjustment for such disorders.

Authors+Show Affiliations

Department of Surgery, P9: 03, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. mats.lindblad@karolinska.seNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15734971

Citation

Lindblad, Mats, et al. "Nonsteroidal Anti-inflammatory Drugs and Risk of Esophageal and Gastric Cancer." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 14, no. 2, 2005, pp. 444-50.
Lindblad M, Lagergren J, García Rodríguez LA. Nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer. Cancer Epidemiol Biomarkers Prev. 2005;14(2):444-50.
Lindblad, M., Lagergren, J., & García Rodríguez, L. A. (2005). Nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 14(2), 444-50.
Lindblad M, Lagergren J, García Rodríguez LA. Nonsteroidal Anti-inflammatory Drugs and Risk of Esophageal and Gastric Cancer. Cancer Epidemiol Biomarkers Prev. 2005;14(2):444-50. PubMed PMID: 15734971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer. AU - Lindblad,Mats, AU - Lagergren,Jesper, AU - García Rodríguez,Luis A, PY - 2005/3/1/pubmed PY - 2005/6/3/medline PY - 2005/3/1/entrez SP - 444 EP - 50 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol Biomarkers Prev VL - 14 IS - 2 N2 - INTRODUCTION: Nonsteroidal anti-inflammatory drugs (NSAID) might reduce risks of esophageal and gastric cancer, but previous studies are limited and provide somewhat conflicting results. METHODS: We tested these associations in a prospective, nested case-control study based on the General Practitioners Research Database, including over 2 million persons in the United Kingdom between 1994 and 2001. In multivariate analyses we calculated odds ratios (OR) with 95% confidence intervals (95% CI). Data were stratified by history of upper gastrointestinal (UGI) disorders and recalculated using 2 years lag time on data (i.e., excluding all information 2 years before index date). RESULTS: Among 4,340,207 person-years of follow-up, we identified 909 patients with esophageal cancer and 1,023 patients with gastric cancer. We randomly selected 10,000 control subjects. Overall analysis suggested that long-term users of nonaspirin NSAIDs were at reduced risks of esophageal (OR, 0.82; 95% CI, 0.57-1.18) and gastric cancer (OR, 0.65; 95% CI, 0.44-0.94), whereas long-term aspirin users might be at decreased risk of esophageal cancer (OR, 0.76; 95% CI, 0.53-1.08), but not of gastric cancer (OR, 1.09; 95% CI, 0.82-1.45). All estimates of reduced risk were weakened in the 2 years lag time analysis except the association between nonaspirin NSAIDs long-term users and gastric cancer. Potentially protective effects were suggestive of being more marked among subjects with a history of UGI disorders. CONCLUSIONS: Nonaspirin NSAIDs long-term use was associated with a reduced risk of gastric cancer, whereas no other studied associations could be firmly established. Our results suggest that UGI disorders could distort the associations, although we could not show this with statistical significance. If such bias was to be true, the previously reported inverse associations might, at least partly, be explained by lack of appropriate adjustment for such disorders. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/15734971/Nonsteroidal_anti_inflammatory_drugs_and_risk_of_esophageal_and_gastric_cancer_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=15734971 DB - PRIME DP - Unbound Medicine ER -