American Journal of Epidemiology Advance Access originally published online on July 27, 2007
American Journal of Epidemiology 2007 166(6):709-716; doi:10.1093/aje/kwm216
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ORIGINAL CONTRIBUTIONS |
Nonsteroidal Antiinflammatory Drug Use and Breast Cancer Risk: Subgroup Findings
1 Division of Preventive Oncology, Research Unit, Cancer Care Ontario, Toronto, Ontario, Canada
2 Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
3 Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
Correspondence to Dr. Victoria A. Kirsh, Division of Preventive Oncology, Cancer Care Ontario, Toronto, Ontario, Canada M5G 2L6 (e-mail: vicki.kirsh{at}cancercare.on.ca).
Received for publication August 22, 2006. Accepted for publication January 31, 2007.
Nonsteroidal antiinflammatory drugs (NSAIDs) may play a role in breast cancer prevention; however, breast cancer subtypes and lifestyle/host factors may influence their impact. During 1996–1998 in Canada, the authors examined the association between regular NSAID use (defined as daily use for at least 2 months) and breast cancer risk by estrogen receptor (ER) and progesterone receptor (PR) status, cigarette smoking exposure, and history of arthritis. Breast cancer cases (n = 3,125, including 1,600 ER+PR+ and 591 ER–PR–) and an age-matched, random sample of controls (n = 3,062) completed a general risk factor questionnaire, including detailed questions on prescription and nonprescription NSAID use. NSAID use was associated with reduced risk of breast cancer (odds ratio = 0.76, 95% confidence interval: 0.66, 0.88). The association was not significantly different for ER+PR+ (odds ratio = 0.71, 95% confidence interval: 0.60, 0.84) and ER–PR– cancers (odds ratio = 0.80, 95% confidence interval: 0.62, 1.03) (pheterogeneity = 0.66). The magnitude of the NSAID inverse association was similar for women with and without arthritis and across smoking strata (risk estimates ranged from 0.74 to 0.84). Breast cancer risk tended to decrease with increasing duration of NSAID use and was generally lowest for 
7 years of use, and both acetylsalicylic acid and non–acetylsalicylic acid use were associated with reduced risks.
anti-inflammatory agents, non-steroidal; arthritis; breast neoplasms; receptors, estrogen; receptors, progesterone; smoking
Abbreviations: CI, confidence interval; ER, estrogen receptor; NSAID, nonsteroidal antiinflammatory drug; OR, odds ratio; PR, progesterone receptor
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