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Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma.
J Natl Cancer Inst. 2012 Dec 05; 104(23):1808-14.JNCI

Abstract

BACKGROUND

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce chronic inflammation and risk of many cancers, but their effect on risk of hepatocellular carcinoma (HCC) and death due to chronic liver disease (CLD) has not been investigated.

METHODS

We analyzed prospective data on 300504 men and women aged 50 to 71 years in the National Institutes of Health-AARP Diet and Health Study cohort and linked self-reported aspirin and nonaspirin NSAID use with registry-confirmed diagnoses of HCC (n=250) and death due to CLD (n=428, excluding HCC). We calculated hazard rate ratios (RRs) and their two-sided 95% confidence intervals (CIs) using Cox proportional hazard regression models with adjustment for age, sex, race/ethnicity, cigarette smoking, alcohol consumption, diabetes, and body mass index. All tests of statistical significance were two-sided.

RESULTS

Aspirin users had statistically significant reduced risks of incidence of HCC (RR = 0.59; 95% CI = 0.45 to 0.77) and mortality due to CLD (RR = 0.55; 95% CI = 0.45 to 0.67) compared to those who did not use aspirin. In contrast, users of nonaspirin NSAIDs had a reduced risk of mortality due to CLD (RR = 0.74; 95% CI= 0.61 to 0.90) but did not have lower risk of incidence of HCC (RR = 1.08; 95% CI = 0.84 to 1.39) compared to those who did not use nonaspirin NSAIDs. The risk estimates did not vary in statistical significance by frequency (monthly, weekly, daily) of aspirin use, but the reduced risk of mortality due to CLD was statistically significant only among monthly users of nonaspirin NSAIDs compared to non-users.

CONCLUSIONS

Aspirin use was associated with reduced risk of developing HCC and of death due to CLD whereas nonaspirin NSAID use was only associated with reduced risk of death due to CLD.

Authors+Show Affiliations

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, EPS 5032, Rockville, MD 20852, USA. vikrant.sahasrabuddhe@nih.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23197492

Citation

Sahasrabuddhe, Vikrant V., et al. "Nonsteroidal Anti-inflammatory Drug Use, Chronic Liver Disease, and Hepatocellular Carcinoma." Journal of the National Cancer Institute, vol. 104, no. 23, 2012, pp. 1808-14.
Sahasrabuddhe VV, Gunja MZ, Graubard BI, et al. Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma. J Natl Cancer Inst. 2012;104(23):1808-14.
Sahasrabuddhe, V. V., Gunja, M. Z., Graubard, B. I., Trabert, B., Schwartz, L. M., Park, Y., Hollenbeck, A. R., Freedman, N. D., & McGlynn, K. A. (2012). Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma. Journal of the National Cancer Institute, 104(23), 1808-14. https://doi.org/10.1093/jnci/djs452
Sahasrabuddhe VV, et al. Nonsteroidal Anti-inflammatory Drug Use, Chronic Liver Disease, and Hepatocellular Carcinoma. J Natl Cancer Inst. 2012 Dec 5;104(23):1808-14. PubMed PMID: 23197492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma. AU - Sahasrabuddhe,Vikrant V, AU - Gunja,Munira Z, AU - Graubard,Barry I, AU - Trabert,Britton, AU - Schwartz,Lauren M, AU - Park,Yikyung, AU - Hollenbeck,Albert R, AU - Freedman,Neal D, AU - McGlynn,Katherine A, Y1 - 2012/11/28/ PY - 2012/12/1/entrez PY - 2012/12/1/pubmed PY - 2013/2/5/medline SP - 1808 EP - 14 JF - Journal of the National Cancer Institute JO - J Natl Cancer Inst VL - 104 IS - 23 N2 - BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce chronic inflammation and risk of many cancers, but their effect on risk of hepatocellular carcinoma (HCC) and death due to chronic liver disease (CLD) has not been investigated. METHODS: We analyzed prospective data on 300504 men and women aged 50 to 71 years in the National Institutes of Health-AARP Diet and Health Study cohort and linked self-reported aspirin and nonaspirin NSAID use with registry-confirmed diagnoses of HCC (n=250) and death due to CLD (n=428, excluding HCC). We calculated hazard rate ratios (RRs) and their two-sided 95% confidence intervals (CIs) using Cox proportional hazard regression models with adjustment for age, sex, race/ethnicity, cigarette smoking, alcohol consumption, diabetes, and body mass index. All tests of statistical significance were two-sided. RESULTS: Aspirin users had statistically significant reduced risks of incidence of HCC (RR = 0.59; 95% CI = 0.45 to 0.77) and mortality due to CLD (RR = 0.55; 95% CI = 0.45 to 0.67) compared to those who did not use aspirin. In contrast, users of nonaspirin NSAIDs had a reduced risk of mortality due to CLD (RR = 0.74; 95% CI= 0.61 to 0.90) but did not have lower risk of incidence of HCC (RR = 1.08; 95% CI = 0.84 to 1.39) compared to those who did not use nonaspirin NSAIDs. The risk estimates did not vary in statistical significance by frequency (monthly, weekly, daily) of aspirin use, but the reduced risk of mortality due to CLD was statistically significant only among monthly users of nonaspirin NSAIDs compared to non-users. CONCLUSIONS: Aspirin use was associated with reduced risk of developing HCC and of death due to CLD whereas nonaspirin NSAID use was only associated with reduced risk of death due to CLD. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/23197492/Nonsteroidal_anti_inflammatory_drug_use_chronic_liver_disease_and_hepatocellular_carcinoma_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djs452 DB - PRIME DP - Unbound Medicine ER -