Aspirin and Other Non-steroidal Anti-Inflammatory Drugs and Risk of Non-Hodgkin Lymphoma
Menée à partir de questionnaires auprès d'une cohorte incluant 149 570 participants (durée de suivi : 15 ans), cette étude évalue, en fonction de la fréquence de consommation, l'effet de l'aspirine et/ou d'anti-inflammatoires non stéroïdiens sur le risque de lymphome non hodgkinien (1 709 cas)
Background: Few large prospective studies have examined associations between non-steroidal anti-inflammatory drug (NSAID) use and non-Hodgkin lymphoma (NHL). Methods: We examined the association between NSAID use and NHL incidence among 149,570 participants in the Cancer Prevention Study-II Nutrition cohort. Aspirin and non-aspirin NSAID use were reported at enrollment in 1992 and updated on periodic follow-up questionnaires. During follow-up through 2007, 1,709 incident NHLs were identified. Time-dependent hazard ratios were calculated using extended Cox regression. Results: Compared to no use, current use of 60+ NSAID pills/month (aspirin and non-aspirin NSAIDs combined) was associated with slightly higher NHL incidence (HR=1.26, 95% CI: 1.04-1.53), but no association with frequency of use was observed when NSAID exposure was lagged by approximately 2 years (HR=1.08, 95% CI: 0.88-1.32). Long duration regular use (current use of 30+ pills/month for >5 years) was not associated with NHL incidence (HR=1.09, 95% CI: 0.91-1.33). In subtype analyses, current use of 60+ NSAID pills/month was associated with follicular lymphoma incidence (HR=1.87, 95% CI: 1.08-3.24). This association persisted when NSAID exposure was lagged (HR=1.76, 95% CI: 1.04-2.98) and was similar for aspirin and non-aspirin NSAIDs. Conclusions: The association of current, but not lagged, NSAID use with risk of all NHL could be attributable to use of NSAIDs to relieve symptoms of undiagnosed NHL. However, the association with follicular lymphoma persisted in analyses where NSAID use was lagged and should be investigated further. Impact: These findings are particularly important for aspirin as the risks and benefits of prophylactic daily use are weighed.