Background: Men of African descent experience a disproportionately high prostate cancer mortality. Intratumoral inflammation was found to be associated with aggressive prostate cancer. We and others have shown that prostate tumors in African-American (AA) patients harbor a distinct immune and inflammation signature when compared with European-American (EA) patients. These observations suggest that inflammation could be a driver of aggressive disease in men of African descent, leading to the hypothesis that an anti-inflammatory drug like aspirin could prevent disease progression. Methods: We examined the relationship between aspirin use and prostate cancer in the NCI-Maryland Prostate Cancer Case-Control Study consisting of 823 men with incident prostate cancer (422 AA and 401 EA) and 1034 population-based men without the disease diagnosis (486 AA and 548 EA). Results: We observed a significant inverse association between regular aspirin use and prostate cancer among AA men. Stratification of AA patients by disease stage showed that daily and long-term (> 3 years) aspirin use significantly decreased the risk of advanced disease (adjusted odds ratios for T3/T4 disease: 0.35, 95% CI: 0.17 to 0.73 and 0.22, 95% CI: 0.08 to 0.60, respectively), but not early-stage disease (T1/T2). Regular aspirin use also reduced disease recurrence in AA men. Conclusions: Regular aspirin use is associated with a decreased risk of advanced stage prostate cancer and increased disease-free survival in AA men. Impact: Regular aspirin use before and after a prostate cancer diagnosis may prevent the development of aggressive disease in AA men who are at risk of a lethal malignancy.
- Received December 16, 2016.
- Revision received February 27, 2017.
- Accepted March 2, 2017.
- Copyright ©2017, American Association for Cancer Research.