Non-steroidal Anti-inflammatory Drugs and Endometrial Cancer Risk in the VITamins And Lifestyle (VITAL) Cohort
A partir d'un questionnaire auprès de 22 268 femmes âgées de 50 à 76 ans (durée de suivi supérieure à 9 ans), cette étude américaine évalue l'association entre la consommation d'anti-inflammatoires non stéroïdiens (dont l'aspirine, l'ibuprofène et le naproxène) et le risque de cancer de l'endomètre (262 cas)
BACKGROUND: Chronic inflammation may be an important factor in the initiation and promotion of endometrial cancer. Use of non-steroidal anti-inflammatory drugs (NSAIDs), however, has been inconsistently associated with endometrial cancer risk. METHODS: 22,268 female residents of western Washington State, ages 50-76, completed a baseline questionnaire in 2000-2002 and reported on their use of individual NSAIDs over the past 10years. Use was categorized as none, low (<4days/week or <4years), and high (>/=4days/week and >/=4years). Over 9 years of follow-up, 262 incident invasive endometrial cancers were identified. Multivariable proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: Relative to non-use, high use of aspirin was inversely associated with endometrial cancer risk (HR 0.64, 95% CI: 0.41-1.01; P trend=0.03). Findings were stronger for regular-strength than low-dose aspirin. High use of non-aspirin NSAIDs (HR 1.15, 95% CI: 0.68-1.95), including ibuprofen (HR 1.29, 95% CI: 0.73-2.28), and naproxen (HR 1.08, 95% CI: 0.39-2.95) were not associated with risk. In subgroup analyses, findings for aspirin were strongest for cancers of endometrioid histology and were restricted to non-smokers. CONCLUSIONS: This study provides additional evidence that use of aspirin, but not non-aspirin NSAIDs, may reduce the risk of endometrial cancer, especially in estrogen-mediated cases; however additional prospective studies with high-quality measurement of NSAID use are needed. Aspirin should continue to be examined as a potential agent for cancer chemoprevention.
http://www.sciencedirect.com/science/article/pii/S0090825812008074