NSAIDs reduce lung cancer risk

Long-term use of anti-inflammatory painkillers (NSAIDs), other than aspirin, appears to reduce the risk of developing lung cancer. Regular use of aspirin or other NSAIDs reduces the risk of colorectal cancer. The effect of NSAIDs on the development and progression of other types of cancer remains controversial. Researchers from the Harvard School of Public Health, Boston examined whether lung cancer risk is influenced by the use of aspirin or other NSAIDs. They studied 40-84 years old subjects in 1995-2004, without a diagnosis of cancer before the study start date, and with at least 2 years of enrolment with a general practitioner providing data to The Health Improvement Network (THIN) database in the UK. Patients who had a first diagnosis of primary lung cancer during the study period were considered cases. A random sample of controls was matched to the cases for age and sex. The index date for exposure definition was 1 year before the date of diagnosis for cases and 1 year before a random date within the study period for controls. There were 4,336 lung cancer patients and 10,000 healthy controls. Aspirin was prescribed to 22 percent of the lung cancer patients and 17 percent of controls, 1-2 years before diagnosis. Nearly 22 percent of cases and controls, were prescribed non-aspirin NSAIDs, at least 13 months before the lung cancer was diagnosed. Compared with non-use, use of NSAIDs, other than aspirin was associated with a 24 percent lesser relative risk of lung cancer. The inverse association between NSAIDs, other than aspirin and lung cancer was more evident in men than women, and was also more apparent for smokers than for non-smokers. No protective effect of aspirin on lung cancer risk was seen, even before long term use and higher doses. Prescription of NSAIDs other than aspirin for at least 1 year might be associated with a slightly reduced risk of lung cancer. Several mechanisms have been proposed to explain the chemopreventive effects of NSAIDs, including enhancement of the immune system and a reduction in inflammation.