Use of Nonsteroidal Anti-inflammatory Drugs and Risk of Ovarian and Endometrial Cancer: The Multiethnic Cohort
Menée sur une cohorte multiethnique de 64 000 femmes, cette étude américaine évalue l'association entre l'utilisation d'anti-inflammatoires non stéroïdiens et le risque de cancer de l'ovaire ou de l'endomètre (895 cas ; durée de suivi : 13,3 ans)
Background: Chronic inflammation may play an etiologic role in ovarian and endometrial cancer, and it is hypothesized that nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the risk of developing these malignancies. No prospective study with a large multiethnic population has explored this hypothesis. Methods: We investigated whether NSAID use was associated with risks of ovarian and endometrial cancer in the Multiethnic Cohort Study. Medication use of at least twice a week for ≥ 1 month was assessed at baseline. Multivariable relative risks (RR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. Results: During an 13.3 years of follow up, 275 ovarian and 620 endometrial incident cases were identified among ~64,000 women included in this analysis (16.5% African Americans, 30.8% Japanese, 7.7% Native Hawaiians, 18.9%, Latinas and 26.0% whites). The RR (95% CI) for ovarian cancer associated with aspirin, non-aspirin NSAIDs, and acetaminophen were 0.87 (0.68, 1.14), 0.97 (0.74, 1.26), and 0.86 (0.67, 1.12), respectively. The RR (95% CI) for endometrial cancer associated with aspirin, non-aspirin NSAIDs, and acetaminophen were 0.93 (0.79, 1.10), 0.88 (0.74, 1.05), 0.96 (0.81, 1.13), respectively. No heterogeneity across ethnic groups (P's ≥0.29) or dose-response relation with increased duration of use (P's for trend ≥0.16) was observed. The results did not differ by tumor histology. Conclusions: We found no compelling evidence to support an association between use of NSAIDs and risk of ovarian and endometrial cancers in a multiethnic population. Impact: It is unlikely that NSAID involves in the etiology of endometrial and ovarian cancer.