Nonsteroidal anti-inflammatory drugs and subsite-specific colorectal cancer incidence in the Iowa Women's Health Study

Amit Mahipal, Kristin E. Anderson, Paul John Limburg, Aaron R. Folsom

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: Previous epidemiologic studies have shown that regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with decreased colorectal cancer risk. However, few studies have examined associations between NSAID use and subsite-specific colorectal cancer risks. Because tumors of the proximal and distal colon differ with respect to their genetic alterations, clinicopathologic features, and demographic distribution, further investigation of subsite-specific colorectal cancer risks may be rewarding. Methods: Data about aspirin and nonaspirin-NSAID use were recorded by self-report in 1992 among the initially cancer-free cohort of postmenopausal women in the Iowa Women's Health Study (n = 27,160). In total, 637 women developed colorectal cancer during the 11 years of follow-up, including 365 proximal colon, 132 distal colon, and 120 rectal cancer cases (11 overlapping and 9 not specified). Results: For colon cancer, the multivariable-adjusted hazard ratios (HR) for women reporting use of aspirin two to five times and six or more times weekly (compared with nonusers of aspirin) were 0.79 [95% confidence interval (95% CI), 0.59-1.04] and 0.76 (95% CI, 0.58-1.00), respectively. The corresponding HRs for nonaspirin NSAIDs were 0.63 (95% CI, 0.41-0.96) and 0.85 (95% CI, 0.63-1.15), respectively. For proximal colon cancer, the multivariable-adjusted HRs for women reporting use of aspirin or nonaspirin NSAIDs two or more times weekly (compared with nonusers of each) were 0.67 (95% CI, 0.51-0.87) and 0.71 (95% CI, 0.52-0.97), respectively. No statistically significant association was found between either distal colon or rectal cancer and aspirin or nonaspirin NSAID use. Discussion: Our study is consistent with a limited number of prior reports that have observed stronger associations between NSAID use and proximal versus distal colorectal cancer.

Original languageEnglish (US)
Pages (from-to)1785-1790
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume15
Issue number10
DOIs
StatePublished - Oct 2006

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Women's Health
Colorectal Neoplasms
Anti-Inflammatory Agents
Aspirin
Confidence Intervals
Incidence
Pharmaceutical Preparations
Colonic Neoplasms
Colon
Rectal Neoplasms
Self Report
Epidemiologic Studies
Neoplasms
Demography

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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Nonsteroidal anti-inflammatory drugs and subsite-specific colorectal cancer incidence in the Iowa Women's Health Study. / Mahipal, Amit; Anderson, Kristin E.; Limburg, Paul John; Folsom, Aaron R.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 15, No. 10, 10.2006, p. 1785-1790.

Research output: Contribution to journalArticle

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abstract = "Background: Previous epidemiologic studies have shown that regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with decreased colorectal cancer risk. However, few studies have examined associations between NSAID use and subsite-specific colorectal cancer risks. Because tumors of the proximal and distal colon differ with respect to their genetic alterations, clinicopathologic features, and demographic distribution, further investigation of subsite-specific colorectal cancer risks may be rewarding. Methods: Data about aspirin and nonaspirin-NSAID use were recorded by self-report in 1992 among the initially cancer-free cohort of postmenopausal women in the Iowa Women's Health Study (n = 27,160). In total, 637 women developed colorectal cancer during the 11 years of follow-up, including 365 proximal colon, 132 distal colon, and 120 rectal cancer cases (11 overlapping and 9 not specified). Results: For colon cancer, the multivariable-adjusted hazard ratios (HR) for women reporting use of aspirin two to five times and six or more times weekly (compared with nonusers of aspirin) were 0.79 [95{\%} confidence interval (95{\%} CI), 0.59-1.04] and 0.76 (95{\%} CI, 0.58-1.00), respectively. The corresponding HRs for nonaspirin NSAIDs were 0.63 (95{\%} CI, 0.41-0.96) and 0.85 (95{\%} CI, 0.63-1.15), respectively. For proximal colon cancer, the multivariable-adjusted HRs for women reporting use of aspirin or nonaspirin NSAIDs two or more times weekly (compared with nonusers of each) were 0.67 (95{\%} CI, 0.51-0.87) and 0.71 (95{\%} CI, 0.52-0.97), respectively. No statistically significant association was found between either distal colon or rectal cancer and aspirin or nonaspirin NSAID use. Discussion: Our study is consistent with a limited number of prior reports that have observed stronger associations between NSAID use and proximal versus distal colorectal cancer.",
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