No clinical evidence that NSAIDs help to prevent prostate cancer
Posted Jun 21 2010 12:00am
Data gathered as part of the ongoing ProtecT study in the United Kingdom provides no evidence that regular use of non-steroidal anti-inflammatory drugs l(NSAIDs) lowers risk for prostate cancer.
Over the years there have been a variety of data from laboratory studies suggesting that chronic inflammation may have a key role in the development of prostate cancer. If this were to be the case, it is reasonable to think that regular use of aspirin, acetaminophen (a.k.a. paracetamol), and other NSAIDs (e.g., ibuprofen, naproxen) might help to prevent the development of prostate cancer, because these are all drugs commonly used to manage the symptoms of chronic forms of inflammatory disease. However, there has been no large, randomized, clinical study carried out to test this hypothesis.
Murad et al. have been able to use data from over 6,000 patients participating in the ProtecT study in the UK. This is an ongoing, nationwide, population-based study designed to investigate the value of PSA testing for the identification of asymptomatic prostate cancers. This is still not a randomized, double-blind, controlled clinical trial like the Prostate Cancer Prevention Trial, but at least it does provide data from a large cohort of patients.
The database included 1,016 men who were tested and diagnosed with prostate cancer as part of the ProtecT initiative and 5,043 men (controls) who were tested but not diagnosed with prostate cancer. Careful analysis of the available data showed that:
Men with a history of using non-aspirin NSAIDs were 1.32 times more likely to be diagnosed with prostate cancer than men who did not use these products.
Men with a history of using any type of NSAID (including aspirin) were 1.25 times more likely to be diagnosed with prostate cancer than men who did not use these products.
Men with a history of using aspirin were 1.13 times more likely to be diagnosed with prostate cancer than men who did not use any from of NSAID (but this was not statistically significant).
Men with a history of using acetaminophen were 1.20 times more likely to be diagnosed with prostate cancer than men who did not use any from of NSAID (but again this was not statistically significant).
There seemed to be no evidence to suggest that age, family history of prostate cancer, body mass index, or self-reported diabetes had any effect on these resulsts.
The use of aspirin, acetominophen, or other NSAIDs was associated with a reduction in the serum PSA concentrations amongst the controls.
The authors conclude that their data ”do not support the hypothesis that NSAIDs reduce the risk of PSA-detected prostate cancer.”