The Association between NSAID use and Colorectal Cancer Mortality: Results from the Women's Health Initiative
Menée sur une cohorte de 160 143 femmes ménopausées, cette étude évalue l'association entre l'utilisation d'anti-inflammatoires non stéroïdiens et le taux de mortalité par cancer colorectal
Background:Randomized trial evidence demonstrates that non-steroidal anti-inflammatory drug (NSAID) use, particularly long-term use, reduces the incidence of colorectal neoplasia. Recent data also suggests an inverse association between NSAID use and death due to colorectal cancer (CRC). Methods:We examined the association between NSAID use and CRC mortality among 160,143 post-menopausal women enrolled in the Women's Health Initiative. Women provided details on medication use at baseline and three years after enrollment. Reported CRC cases were locally confirmed and centrally adjudicated; cause of death was determined according to centralized medical record and death certificate review. Cox regression was used to investigate the association between NSAID use and CRC mortality. Results:Overall, NSAID use at baseline was not associated with CRC mortality (HR: 0.93; 95% CI 0.76, 1.14). However, women who reported NSAID use at both baseline and year-three experienced reductions in CRC mortality (HR: 0.72; 95% CI 0.54, 0.95) compared to non-users. Conclusions:Results suggest that NSAID use is associated with lower CRC mortality among post-menopausal women who use these medications more consistently over time. Impact:Our results support prolonged NSAID use in post-menopausal women for the prevention of poor CRC outcomes.