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American Journal of Epidemiology Advance Access published online on June 22, 2005
American Journal of Epidemiology, doi:10.1093/aje/kwi182
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved
Received November 30, 2004
Accepted March 22, 2005

ORIGINAL CONTRIBUTIONS

Use of Nonsteroidal Antiinflammatory Drugs and Risk of Breast Cancer: The Case-Control Surveillance Study Revisited

Yuqing Zhang 1*, Patricia F. Coogan 2, Julie R. Palmer 2, Brian L. Strom 3, and Lynn Rosenberg 2

1 Clinical Epidemiology Research and Training Unit, School of Medicine, Boston University, Boston, MA
2 Slone Epidemiology Center, Boston University, Boston, MA
3 Center for Clinical Epidemiology and Biostatistics; Department of Biostatistics and Epidemiology; Center for Education and Research on Therapeutics; and Division of General Internal Medicine, Department of Medicine; University of Pennsylvania School of Medicine, Philadelphia, PA

* To whom correspondence should be addressed.
Yuqing Zhang, E-mail: yuqing{at}bu.edu


  Abstract

Several studies have suggested that use of nonsteroidal antiinflammatory drugs (NSAIDs) may reduce the risk of breast cancer. Reductions in risk may vary according to the hormone receptor status of the tumor or the type of NSAID used. The authors extended a previous US hospital-based case-control study (the Case-Control Surveillance Study) to include 444 additional cases, for a total of 7,006 incident breast cancer cases (1976-2002). They examined the relation between regular NSAID use and breast cancer risk using logistic regression to adjust for confounding. The odds ratio for regular use of NSAIDs was 0.78 (95% confidence interval: 0.63, 0.97), and a trend of decreasing risk with increasing duration of use was statistically significant (p for trend = 0.02). The inverse association with regular use of NSAIDs was stronger among premenopausal women (odds ratio = 0.62). The overall odds ratios for regular use of aspirin and ibuprofen were 0.86 and 0.85, respectively. The effect of NSAID use on breast cancer risk did not vary according to the hormone receptor status of the tumor. In conclusion, long-term regular use of NSAIDs was associated with decreased risk of breast cancer. The type of NSAID used or the hormone receptor status of the tumor did not modify the effect.

Keywords: anti-inflammatory agents, non-steroidal; breast neoplasms; case-control studies.
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