Non-steroidal anti-inflammatory drugs and the risk of oral cancer : a nested case-control study

• Published in: The Lancet (British edition) 2005-10, Vol.366 (9494), p.1359-1366
• Main Authors: SUDBØ, J, LEE, J. J, KILDAL, W, EVENSEN, J. F, REITH, A, DANNENBERG, A. J, LIPPMAN, S. M, MORK, J, SAGEN, S, FLATNER, N, RISTIMAKI, A, SUDBØ, A, MAO, L, ZHOU, X
• Format: Article
• Language: English
• Subjects: Acetaminophen - therapeutic use; Aged; Analgesics, Non-Narcotic - therapeutic use; Anti-inflammatory agents; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Anticarcinogenic Agents - therapeutic use; Biological and medical sciences; Cancer; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - mortality; Case studies; Case-Control Studies; Deoxyribonucleic acid; DNA; Female; General aspects; Health risks; Health Surveys; Humans; Lesions; Male; Medical sciences; Metabolites; Middle Aged; Mortality; Mouth; Mouth Neoplasms - epidemiology; Mouth Neoplasms - etiology; Mouth Neoplasms - prevention & control; Mutagenicity; Nonsteroidal anti-inflammatory drugs; Norway - epidemiology; Otorhinolaryngology. Stomatology; Polycyclic aromatic hydrocarbons; Risk Factors; Side effects; Smoke; Smoking - adverse effects; Tobacco; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(05)67488-0

Non-steroidal anti-inflammatory drugs (NSAIDs) seem to prevent several types of cancer, but could increase the risk of cardiovascular complications. We investigated whether use of NSAIDs was associated with a change in the incidence of oral cancer or overall or cardiovascular mortality. We undertook a nested case-control study to analyse data from a population-based database (Cohort of Norway; CONOR), which consisted of prospectively obtained health data from all regions of Norway. People with oral cancer were identified from the 9241 individuals in CONOR who were at increased risk of oral cancer because of heavy smoking (15 pack-years), and matched controls were selected from the remaining heavy smokers (who did not have cancer). We identified and analysed 454 (5%) people with oral cancer (279 men, 175 women, mean [SD] age at diagnosis 63.3 [13.2] years) and 454 matched controls (n=908); 263 (29%) had used NSAIDs, 83 (9%) had used paracetamol (for a minimum of 6 months), and 562 (62%) had used neither drug. NSAID use (but not paracetamol use) was associated with a reduced risk of oral cancer (including in active smokers; hazard ratio 0.47, 95% CI 0.37-0.60, p