Aspirin and Nonsteroidal Anti-inflammatory Drug Use and Risk of Pancreatic Cancer: A Meta-analysis

  1. Susanna C. Larsson1,
  2. Edward Giovannucci2,3,
  3. Leif Bergkvist4 and
  4. Alicja Wolk1
  1. 1Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 2Departments of Nutrition and Epidemiology, Harvard School of Public Health; 3Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and 4Department of Surgery and Centre for Clinical Research, Central Hospital, Västerås, Sweden
  1. Requests for reprints:
    Susanna C. Larsson, Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-17177 Stockholm, Sweden. Phone: 46-8-52486059; Fax: 46-8-304571. E-mail: susanna.larsson{at}ki.se

Abstract

Background: The association between use of nonsteroidal anti-inflammatory drugs (NSAID), including aspirin, and risk of pancreatic cancer is controversial. We did a meta-analysis to summarize available evidence from epidemiologic studies investigating the relation between use of aspirin or other NSAIDs and the risk of pancreatic cancer.

Methods: We identified potential studies by searching the MEDLINE database (from 1966 to October 2006) and by reviewing the reference lists of pertinent publications. Studies were eligible for inclusion if they met the following criteria: (a) had a case-control or prospective design, (b) examined exposure to aspirin or NSAIDs, (c) the outcome was pancreatic cancer incidence or mortality, and (d) they provided a relative risk (RR) estimate with corresponding confidence interval or sufficient information to permit their calculation. Study-specific RR estimates were pooled using a random effects model.

Results: A total of 11 studies (3 case-control studies, 7 cohort studies, and 1 randomized trial), involving 6,386 pancreatic cancer cases, was included in the meta-analysis. The summary RR estimate did not indicate any association between aspirin/NSAID use and risk of pancreatic cancer [any/regular use versus nonregular/never use: RR, 1.01; 95% confidence interval (95% CI), 0.91-1.11; Pheterogeneity = 0.09]. Neither use of aspirin, nonaspirin NSAIDs, nor overall NSAIDs were associated with pancreatic cancer risk. There was also no overall association with frequent (six or more tablets/times per week versus none: RR, 0.86; 95% CI, 0.61-1.23) or long-term (≥20 years) use of aspirin (RR, 1.21; 95% CI, 0.74-1.96).

Conclusions: Current epidemiologic evidence does not indicate that use of aspirin or NSAIDs is associated with the risk of pancreatic cancer. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2561–4)

Footnotes

  • Grant support: Swedish Cancer Society and Swedish Foundation for International Cooperation in Research and Higher Education.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted September 18, 2006.
    • Received July 13, 2006.
    • Revision received August 24, 2006.
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  1. doi: 10.1158/1055-9965.EPI-06-0574 Cancer Epidemiology, Biomarkers & Prevention December 1, 2006 15, 2561
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