A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer

Rosebud O Roberts, Debra J. Jacobson, Cynthia J. Girman, Thomas Rhodes, Michael M. Lieber, Steven J. Jacobsen

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Abstract

Objective: To investigate the association between daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) and prostate cancer. Patients and Methods: Subjects were 50- to 79-year-old white men randomly selected in January 1990 from the Olmsted County, Minnesota, community (n=1362) from among participants in a longitudinal study of lower urinary tract symptoms. At the beginning of the study, all medications that were used daily, including prescription and nonprescription NSAIDs, were ascertained by trained interviewers. Men who developed a histologically proved diagnosis of prostate cancer during a median of 66 months (maximum, 6 years) of follow-up were identified from a complete review of the community medical record. Results: Twenty-three (4%) of 569 NSAID users and 68 (9%) of 793 nonusers developed prostate cancer during follow-up (P=.001). The relative odds of prostate cancer were 0.45 (95% confidence interval [CI], 0.28-0.73) in NSAID users compared with nonusers. This inverse association with NSAID use increased with increasing age at study onset. Thus, the relative odds of prostate cancer among NSAID users were 0.9 (95% CI, 0.4-2.2) in men aged 50 to 59 years, 0.4 (95% CI, 0.2-0.8) in men aged 60 to 69 years, and 0.2 (95% CI, 0.1-0.5) in men aged 70 to 79 years compared with similarly aged men who did not use NSAIDs. Conclusion: The study findings suggest that daily use of NSAIDs may be associated with a lower incidence of prostate cancer in men aged 60 years or older. The stronger effect among older men suggests that NSAIDs may prevent the progression of prostate cancer from latent to clinical disease.

Original languageEnglish (US)
Pages (from-to)219-225
Number of pages7
JournalMayo Clinic Proceedings
Volume77
Issue number3
StatePublished - 2002

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Prostatic Neoplasms
Anti-Inflammatory Agents
Pharmaceutical Preparations
Population
Drug Users
Confidence Intervals
Odds Ratio
Lower Urinary Tract Symptoms
Age of Onset
Medical Records
Prescriptions
Longitudinal Studies
Interviews
Incidence

Keywords

  • BPH = benign prostatic hyperplasia
  • CI = confidence interval
  • COX-2 = cyclooxygenase 2
  • DRE = digital rectal examination
  • NSAID = nonsteroidal anti-inflammatory drug
  • OR = odds ratio
  • PSA = prostate-specific antigen

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Roberts, R. O., Jacobson, D. J., Girman, C. J., Rhodes, T., Lieber, M. M., & Jacobsen, S. J. (2002). A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer. Mayo Clinic Proceedings, 77(3), 219-225.

A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer. / Roberts, Rosebud O; Jacobson, Debra J.; Girman, Cynthia J.; Rhodes, Thomas; Lieber, Michael M.; Jacobsen, Steven J.

In: Mayo Clinic Proceedings, Vol. 77, No. 3, 2002, p. 219-225.

Research output: Contribution to journalArticle

Roberts, RO, Jacobson, DJ, Girman, CJ, Rhodes, T, Lieber, MM & Jacobsen, SJ 2002, 'A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer', Mayo Clinic Proceedings, vol. 77, no. 3, pp. 219-225.
Roberts RO, Jacobson DJ, Girman CJ, Rhodes T, Lieber MM, Jacobsen SJ. A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer. Mayo Clinic Proceedings. 2002;77(3):219-225.
Roberts, Rosebud O ; Jacobson, Debra J. ; Girman, Cynthia J. ; Rhodes, Thomas ; Lieber, Michael M. ; Jacobsen, Steven J. / A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer. In: Mayo Clinic Proceedings. 2002 ; Vol. 77, No. 3. pp. 219-225.
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abstract = "Objective: To investigate the association between daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) and prostate cancer. Patients and Methods: Subjects were 50- to 79-year-old white men randomly selected in January 1990 from the Olmsted County, Minnesota, community (n=1362) from among participants in a longitudinal study of lower urinary tract symptoms. At the beginning of the study, all medications that were used daily, including prescription and nonprescription NSAIDs, were ascertained by trained interviewers. Men who developed a histologically proved diagnosis of prostate cancer during a median of 66 months (maximum, 6 years) of follow-up were identified from a complete review of the community medical record. Results: Twenty-three (4{\%}) of 569 NSAID users and 68 (9{\%}) of 793 nonusers developed prostate cancer during follow-up (P=.001). The relative odds of prostate cancer were 0.45 (95{\%} confidence interval [CI], 0.28-0.73) in NSAID users compared with nonusers. This inverse association with NSAID use increased with increasing age at study onset. Thus, the relative odds of prostate cancer among NSAID users were 0.9 (95{\%} CI, 0.4-2.2) in men aged 50 to 59 years, 0.4 (95{\%} CI, 0.2-0.8) in men aged 60 to 69 years, and 0.2 (95{\%} CI, 0.1-0.5) in men aged 70 to 79 years compared with similarly aged men who did not use NSAIDs. Conclusion: The study findings suggest that daily use of NSAIDs may be associated with a lower incidence of prostate cancer in men aged 60 years or older. The stronger effect among older men suggests that NSAIDs may prevent the progression of prostate cancer from latent to clinical disease.",
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AU - Lieber, Michael M.

AU - Jacobsen, Steven J.

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N2 - Objective: To investigate the association between daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) and prostate cancer. Patients and Methods: Subjects were 50- to 79-year-old white men randomly selected in January 1990 from the Olmsted County, Minnesota, community (n=1362) from among participants in a longitudinal study of lower urinary tract symptoms. At the beginning of the study, all medications that were used daily, including prescription and nonprescription NSAIDs, were ascertained by trained interviewers. Men who developed a histologically proved diagnosis of prostate cancer during a median of 66 months (maximum, 6 years) of follow-up were identified from a complete review of the community medical record. Results: Twenty-three (4%) of 569 NSAID users and 68 (9%) of 793 nonusers developed prostate cancer during follow-up (P=.001). The relative odds of prostate cancer were 0.45 (95% confidence interval [CI], 0.28-0.73) in NSAID users compared with nonusers. This inverse association with NSAID use increased with increasing age at study onset. Thus, the relative odds of prostate cancer among NSAID users were 0.9 (95% CI, 0.4-2.2) in men aged 50 to 59 years, 0.4 (95% CI, 0.2-0.8) in men aged 60 to 69 years, and 0.2 (95% CI, 0.1-0.5) in men aged 70 to 79 years compared with similarly aged men who did not use NSAIDs. Conclusion: The study findings suggest that daily use of NSAIDs may be associated with a lower incidence of prostate cancer in men aged 60 years or older. The stronger effect among older men suggests that NSAIDs may prevent the progression of prostate cancer from latent to clinical disease.

AB - Objective: To investigate the association between daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) and prostate cancer. Patients and Methods: Subjects were 50- to 79-year-old white men randomly selected in January 1990 from the Olmsted County, Minnesota, community (n=1362) from among participants in a longitudinal study of lower urinary tract symptoms. At the beginning of the study, all medications that were used daily, including prescription and nonprescription NSAIDs, were ascertained by trained interviewers. Men who developed a histologically proved diagnosis of prostate cancer during a median of 66 months (maximum, 6 years) of follow-up were identified from a complete review of the community medical record. Results: Twenty-three (4%) of 569 NSAID users and 68 (9%) of 793 nonusers developed prostate cancer during follow-up (P=.001). The relative odds of prostate cancer were 0.45 (95% confidence interval [CI], 0.28-0.73) in NSAID users compared with nonusers. This inverse association with NSAID use increased with increasing age at study onset. Thus, the relative odds of prostate cancer among NSAID users were 0.9 (95% CI, 0.4-2.2) in men aged 50 to 59 years, 0.4 (95% CI, 0.2-0.8) in men aged 60 to 69 years, and 0.2 (95% CI, 0.1-0.5) in men aged 70 to 79 years compared with similarly aged men who did not use NSAIDs. Conclusion: The study findings suggest that daily use of NSAIDs may be associated with a lower incidence of prostate cancer in men aged 60 years or older. The stronger effect among older men suggests that NSAIDs may prevent the progression of prostate cancer from latent to clinical disease.

KW - BPH = benign prostatic hyperplasia

KW - CI = confidence interval

KW - COX-2 = cyclooxygenase 2

KW - DRE = digital rectal examination

KW - NSAID = nonsteroidal anti-inflammatory drug

KW - OR = odds ratio

KW - PSA = prostate-specific antigen

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