Skip to main content
Top
Published in: Breast Cancer Research and Treatment 1/2009

01-09-2009 | Epidemiology

Association between NSAIDs use and breast cancer risk: a systematic review and meta-analysis

Authors: Ya-shuang Zhao, Sui Zhu, Xiang-wei Li, Fan Wang, Fu-lan Hu, Dan-dan Li, Wen-cui Zhang, Xia Li

Published in: Breast Cancer Research and Treatment | Issue 1/2009

Login to get access

Abstract

The association between non-steroidal anti-inflammatory drugs (NSAIDs) use and breast cancer has remained controversial. Therefore, an overall quantitative estimate of the association needs to be studied. A systematic review and meta-analysis was executed to explore the pooled estimate for relative risk (RR) and 95% confidence interval (CI) using random or fixed effects models based on heterogeneity analysis. Overall 26 studies with 528,705 participants were included. The RR of NSAIDs use and the incidence of breast cancer was 0.94 (95% CI: 0.88–1.00) with random effects model. A slight reduction of breast cancer by taking aspirin and ibuprofen was both observed with pooled RR of 0.91 (95% CI: 0.83–0.98) and 0.81 (95% CI: 0.67–0.97), respectively. Our results indicate that NSAIDs use is associated with a slight decrease for the development of breast cancer with a marginally statistical significant difference. The associations are slightly more obvious in aspirin and ibuprofen use.
Literature
1.
go back to reference Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57(1):43–66PubMedCrossRef Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57(1):43–66PubMedCrossRef
2.
4.
go back to reference Kune GA, Kune S, Watson LF (1988) Colorectal cancer risk, chronic illnesses, operations, and medications: case control results from the Melbourne colorectal cancer study. Cancer Res 48(15):4399–4404PubMed Kune GA, Kune S, Watson LF (1988) Colorectal cancer risk, chronic illnesses, operations, and medications: case control results from the Melbourne colorectal cancer study. Cancer Res 48(15):4399–4404PubMed
5.
go back to reference Suh O, Mettlin C, Petrelli NJ (1993) Aspirin use, cancer, and polyps of the large bowel. Cancer 72(4):1171–1177. doi :10.1002/1097-0142(19930815)72:4<1171::AID-CNCR2820720407>3.0.CO;2-DPubMedCrossRef Suh O, Mettlin C, Petrelli NJ (1993) Aspirin use, cancer, and polyps of the large bowel. Cancer 72(4):1171–1177. doi :10.1002/1097-0142(19930815)72:4<1171::AID-CNCR2820720407>3.0.CO;2-DPubMedCrossRef
6.
go back to reference Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Willett WC (1994) Aspirin use and the risk for colorectal cancer and adenoma in male health professionals. Ann Intern Med 121(4):241–246PubMed Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Willett WC (1994) Aspirin use and the risk for colorectal cancer and adenoma in male health professionals. Ann Intern Med 121(4):241–246PubMed
9.
go back to reference Slattery ML, Samowitz W, Hoffman M, Ma KN, Levin TR, Neuhausen S (2004) Aspirin, NSAIDs, and colorectal cancer: possible involvement in an insulin-related pathway. Cancer Epidemiol Biomarkers Prev 13(4):538–545PubMed Slattery ML, Samowitz W, Hoffman M, Ma KN, Levin TR, Neuhausen S (2004) Aspirin, NSAIDs, and colorectal cancer: possible involvement in an insulin-related pathway. Cancer Epidemiol Biomarkers Prev 13(4):538–545PubMed
10.
go back to reference Chan AT, Giovannucci EL, Meyerhardt JA, Schernhammer ES, Curhan GC, Fuchs CS (2005) Long-term use of aspirin and nonsteroidal anti-inflammatory drugs and risk of colorectal cancer. J Am Med Assoc 294(8):914–923. doi:10.1001/jama.294.8.914 CrossRef Chan AT, Giovannucci EL, Meyerhardt JA, Schernhammer ES, Curhan GC, Fuchs CS (2005) Long-term use of aspirin and nonsteroidal anti-inflammatory drugs and risk of colorectal cancer. J Am Med Assoc 294(8):914–923. doi:10.​1001/​jama.​294.​8.​914 CrossRef
11.
go back to reference Dube C, Rostom A, Lewin G et al (2007) The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. preventive services task force. Ann Intern Med 146(5):365–375PubMed Dube C, Rostom A, Lewin G et al (2007) The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. preventive services task force. Ann Intern Med 146(5):365–375PubMed
12.
go back to reference Gonzalez-Perez A, Garcia Rodriguez LA, Lopez-Ridaura R (2003) Effects of non-steroidal anti-inflammatory drugs on cancer sites other than the colon and rectum: a meta-analysis. BMC Cancer 3:28PubMedCrossRef Gonzalez-Perez A, Garcia Rodriguez LA, Lopez-Ridaura R (2003) Effects of non-steroidal anti-inflammatory drugs on cancer sites other than the colon and rectum: a meta-analysis. BMC Cancer 3:28PubMedCrossRef
14.
go back to reference Mangiapane S, Blettner M, Schlattmann P (2008) Aspirin use and breast cancer risk: a meta-analysis and meta-regression of observational studies from 2001 to 2005. Pharmacoepidemiol Drug Saf 17(2):115–124. doi:10.1002/pds.1503 PubMedCrossRef Mangiapane S, Blettner M, Schlattmann P (2008) Aspirin use and breast cancer risk: a meta-analysis and meta-regression of observational studies from 2001 to 2005. Pharmacoepidemiol Drug Saf 17(2):115–124. doi:10.​1002/​pds.​1503 PubMedCrossRef
15.
go back to reference Cook NR, Lee IM, Gaziano JM et al (2005) Low-dose aspirin in the primary prevention of cancer: the Women’s Health Study: a randomized controlled trial. J Am Med Assoc 294(1):47–55. doi:10.1001/jama.294.1.47 CrossRef Cook NR, Lee IM, Gaziano JM et al (2005) Low-dose aspirin in the primary prevention of cancer: the Women’s Health Study: a randomized controlled trial. J Am Med Assoc 294(1):47–55. doi:10.​1001/​jama.​294.​1.​47 CrossRef
16.
go back to reference Gaudet MM, Gammon MD, Santella RM et al (2005) MnSOD Val-9Ala genotype, pro- and anti-oxidant environmental modifiers, and breast cancer among women on long Island, New York. Cancer Causes Control 16(10):1225–1234. doi:10.1007/s10552-005-0375-6 PubMedCrossRef Gaudet MM, Gammon MD, Santella RM et al (2005) MnSOD Val-9Ala genotype, pro- and anti-oxidant environmental modifiers, and breast cancer among women on long Island, New York. Cancer Causes Control 16(10):1225–1234. doi:10.​1007/​s10552-005-0375-6 PubMedCrossRef
17.
go back to reference Rahme E, Ghosn J, Dasgupta K, Rajan R, Hudson M (2005) Association between frequent use of nonsteroidal anti-inflammatory drugs and breast cancer. BMC Cancer 5:159PubMedCrossRef Rahme E, Ghosn J, Dasgupta K, Rajan R, Hudson M (2005) Association between frequent use of nonsteroidal anti-inflammatory drugs and breast cancer. BMC Cancer 5:159PubMedCrossRef
18.
go back to reference Stevens VL, Rodriguez C, Pavluck AL, Thun MJ, Calle EE (2006) Association of polymorphisms in the paraoxonase 1 gene with breast cancer incidence in the CPS-II nutrition cohort. Cancer Epidemiol Biomarkers Prev 15(6):1226–1228. doi:10.1158/1055-9965.EPI-05-0930 PubMedCrossRef Stevens VL, Rodriguez C, Pavluck AL, Thun MJ, Calle EE (2006) Association of polymorphisms in the paraoxonase 1 gene with breast cancer incidence in the CPS-II nutrition cohort. Cancer Epidemiol Biomarkers Prev 15(6):1226–1228. doi:10.​1158/​1055-9965.​EPI-05-0930 PubMedCrossRef
19.
20.
go back to reference Harris RE, Beebe-Donk J, Alshafie GA (2006) Reduction in the risk of human breast cancer by selective cyclooxygenase-2 (COX-2) inhibitors. BMC Cancer 6:27PubMedCrossRef Harris RE, Beebe-Donk J, Alshafie GA (2006) Reduction in the risk of human breast cancer by selective cyclooxygenase-2 (COX-2) inhibitors. BMC Cancer 6:27PubMedCrossRef
21.
go back to reference Shen J, Gammon MD, Terry MB, Teitelbaum SL, Neugut AI, Santella RM (2006) Genetic polymorphisms in the cyclooxygenase-2 gene, use of nonsteroidal anti-inflammatory drugs, and breast cancer risk. Breast Cancer Res 8(6):R71. doi:10.1186/bcr1629 PubMedCrossRef Shen J, Gammon MD, Terry MB, Teitelbaum SL, Neugut AI, Santella RM (2006) Genetic polymorphisms in the cyclooxygenase-2 gene, use of nonsteroidal anti-inflammatory drugs, and breast cancer risk. Breast Cancer Res 8(6):R71. doi:10.​1186/​bcr1629 PubMedCrossRef
22.
go back to reference Gallicchio L, McSorley MA, Newschaffer CJ et al (2006) Nonsteroidal antiinflammatory drugs, cyclooxygenase polymorphisms, and the risk of developing breast carcinoma among women with benign breast disease. Cancer 106(7):1443–1452. doi:10.1002/cncr.21763 PubMedCrossRef Gallicchio L, McSorley MA, Newschaffer CJ et al (2006) Nonsteroidal antiinflammatory drugs, cyclooxygenase polymorphisms, and the risk of developing breast carcinoma among women with benign breast disease. Cancer 106(7):1443–1452. doi:10.​1002/​cncr.​21763 PubMedCrossRef
23.
go back to reference Vogel U, Christensen J, Nexø BA, Wallin H, Friis S, Tjønneland A (2007) Peroxisome profilerator-activated receptorg2 Pro12Ala, interaction with alcohol intake and NSAID use, in relation to risk of breast cancer in a prospective study of Danes. Carcinogenesis 28(2):427–434. doi:10.1093/carcin/bgl170 PubMedCrossRef Vogel U, Christensen J, Nexø BA, Wallin H, Friis S, Tjønneland A (2007) Peroxisome profilerator-activated receptorg2 Pro12Ala, interaction with alcohol intake and NSAID use, in relation to risk of breast cancer in a prospective study of Danes. Carcinogenesis 28(2):427–434. doi:10.​1093/​carcin/​bgl170 PubMedCrossRef
25.
go back to reference Slattery ML, Curtin K, Baumgartner R et al (2007) IL6, aspirin, nonsteroidal anti-inflammatory drugs, and breast cancer risk in women living in the southwestern United States. Cancer Epidemiol Biomarkers Prev 16(4):747–755. doi:10.1158/1055-9965.EPI-06-0667 PubMedCrossRef Slattery ML, Curtin K, Baumgartner R et al (2007) IL6, aspirin, nonsteroidal anti-inflammatory drugs, and breast cancer risk in women living in the southwestern United States. Cancer Epidemiol Biomarkers Prev 16(4):747–755. doi:10.​1158/​1055-9965.​EPI-06-0667 PubMedCrossRef
26.
go back to reference Gallicchio L, Visvanathan K, Burke A, Hoffman SC, Helzlsouer KJ (2007) Nonsteroidal anti-inflammatory drugs and the risk of developing breast cancer in a population-based prospective cohort study in Washington County, MD. Int J Cancer 121(1):211–215. doi:10.1002/ijc.22656 PubMedCrossRef Gallicchio L, Visvanathan K, Burke A, Hoffman SC, Helzlsouer KJ (2007) Nonsteroidal anti-inflammatory drugs and the risk of developing breast cancer in a population-based prospective cohort study in Washington County, MD. Int J Cancer 121(1):211–215. doi:10.​1002/​ijc.​22656 PubMedCrossRef
27.
28.
go back to reference Jacobs EJ, Thun MJ, Bain ER, Rodriguez C, Henley SJ, Calle EE (2007) A large cohort study of long term daily use of adult-strength aspirin and cancer incidence. J Natl Cancer Inst 99:608–615PubMedCrossRef Jacobs EJ, Thun MJ, Bain ER, Rodriguez C, Henley SJ, Calle EE (2007) A large cohort study of long term daily use of adult-strength aspirin and cancer incidence. J Natl Cancer Inst 99:608–615PubMedCrossRef
30.
go back to reference Gill JK, Maskarinec G, Wilkens LR, Pike MC, Henderson BE, Kolonel LN (2007) Nonsteroidal antiinflammatory drugs and breast cancer risk: the multiethnic cohort. Am J Epidemiol 166(10):1150–1158. doi:10.1093/aje/kwm195 PubMedCrossRef Gill JK, Maskarinec G, Wilkens LR, Pike MC, Henderson BE, Kolonel LN (2007) Nonsteroidal antiinflammatory drugs and breast cancer risk: the multiethnic cohort. Am J Epidemiol 166(10):1150–1158. doi:10.​1093/​aje/​kwm195 PubMedCrossRef
31.
go back to reference Harris RE, Beebe-Donk J, Alshafie GA (2007) Cancer chemoprevention by cyclooxygenase 2 (COX-2) blockade: results of case control studies. Subcell Biochem 42:193–212PubMedCrossRef Harris RE, Beebe-Donk J, Alshafie GA (2007) Cancer chemoprevention by cyclooxygenase 2 (COX-2) blockade: results of case control studies. Subcell Biochem 42:193–212PubMedCrossRef
35.
go back to reference Friis S, Thomassen L, Sorensen HT et al (2008) Nonsteroidal anti-inflammatory drug use and breast cancer risk: a Danish cohort study. Eur J Cancer Prev 17(2):88–96PubMedCrossRef Friis S, Thomassen L, Sorensen HT et al (2008) Nonsteroidal anti-inflammatory drug use and breast cancer risk: a Danish cohort study. Eur J Cancer Prev 17(2):88–96PubMedCrossRef
39.
go back to reference Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634PubMed Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634PubMed
41.
go back to reference Friedman GD, Ury HK (1980) Initial screening for carcinogenicity of commonly used drugs. J Natl Cancer Inst 65(4):723–733PubMed Friedman GD, Ury HK (1980) Initial screening for carcinogenicity of commonly used drugs. J Natl Cancer Inst 65(4):723–733PubMed
42.
go back to reference Thun MJ, Namboodri MM, Calle EE, Flanders WD, Heath C Jr (1993) Aspirin use and risk of fetal cancer. Cancer Res 53:1322–1327PubMed Thun MJ, Namboodri MM, Calle EE, Flanders WD, Heath C Jr (1993) Aspirin use and risk of fetal cancer. Cancer Res 53:1322–1327PubMed
45.
go back to reference Marshall SF, Bernstein L, Anton-Culver H et al (2005) Nonsteroidal anti-inflammatory drug use and breast cancer risk by stage and hormone receptor status. J Natl Cancer Inst 97(11):805–812PubMedCrossRef Marshall SF, Bernstein L, Anton-Culver H et al (2005) Nonsteroidal anti-inflammatory drug use and breast cancer risk by stage and hormone receptor status. J Natl Cancer Inst 97(11):805–812PubMedCrossRef
47.
go back to reference Friis S, Sorensen HT, McLaughlin JK, Johnsen SP, Blot WJ, Olsen JH (2003) A population-based cohort study of the risk of colorectal and other cancers among users of low-dose aspirin. Br J Cancer 88(5):684–688. doi:10.1038/sj.bjc.6600760 PubMedCrossRef Friis S, Sorensen HT, McLaughlin JK, Johnsen SP, Blot WJ, Olsen JH (2003) A population-based cohort study of the risk of colorectal and other cancers among users of low-dose aspirin. Br J Cancer 88(5):684–688. doi:10.​1038/​sj.​bjc.​6600760 PubMedCrossRef
51.
go back to reference Neugut AI, Rosenberg DJ, Ahsan H et al (1998) Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomarkers Prev 7(10):869–873PubMed Neugut AI, Rosenberg DJ, Ahsan H et al (1998) Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomarkers Prev 7(10):869–873PubMed
55.
go back to reference Sharpe CR, Collet JP, McNutt M, Belzile E, Boivin JF, Hanley JA (2000) Nested case–control study of the effects of non-steroidal anti-inflammatory drugs on breast cancer risk and stage. Br J Cancer 83(1):112–120. doi:10.1054/bjoc.2000.1119 PubMedCrossRef Sharpe CR, Collet JP, McNutt M, Belzile E, Boivin JF, Hanley JA (2000) Nested case–control study of the effects of non-steroidal anti-inflammatory drugs on breast cancer risk and stage. Br J Cancer 83(1):112–120. doi:10.​1054/​bjoc.​2000.​1119 PubMedCrossRef
56.
go back to reference Cotterchio M, Kreiger N, Sloan M, Steingart A (2001) Nonsteroidal anti-inflammatory drug use and breast cancer risk. Cancer Epidemiol Biomarkers Prev 10(11):1213–1217PubMed Cotterchio M, Kreiger N, Sloan M, Steingart A (2001) Nonsteroidal anti-inflammatory drug use and breast cancer risk. Cancer Epidemiol Biomarkers Prev 10(11):1213–1217PubMed
59.
60.
go back to reference Paganini-Hill A, Chao A, Ross RK, Henderson BE (1989) Aspirin use and chronic diseases: a cohort study of the elderly. BMJ 299(6710):1247–1250PubMedCrossRef Paganini-Hill A, Chao A, Ross RK, Henderson BE (1989) Aspirin use and chronic diseases: a cohort study of the elderly. BMJ 299(6710):1247–1250PubMedCrossRef
61.
go back to reference Harris RE, Kasbari S, Farrar WB (1999) Prospective study of nonsteroidal anti-inflammatory drugs and breast cancer. Oncol Rep 6(1):71–73PubMed Harris RE, Kasbari S, Farrar WB (1999) Prospective study of nonsteroidal anti-inflammatory drugs and breast cancer. Oncol Rep 6(1):71–73PubMed
63.
go back to reference Johnson TW, Anderson KE, Lazovich D, Folsom AR (2002) Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. Cancer Epidemiol Biomarkers Prev 11(12):1586–1591PubMed Johnson TW, Anderson KE, Lazovich D, Folsom AR (2002) Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. Cancer Epidemiol Biomarkers Prev 11(12):1586–1591PubMed
64.
go back to reference Harris RE, Chlebowski RT, Jackson RD et al (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the Women’s Health Initiative. Cancer Res 63(18):6096–6101PubMed Harris RE, Chlebowski RT, Jackson RD et al (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the Women’s Health Initiative. Cancer Res 63(18):6096–6101PubMed
65.
go back to reference Jacobs EJ, Thun MJ, Connell CJ et al (2005) Aspirin and other nonsteroidal anti-inflammatory drugs and breast cancer incidence in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 14(1):261–264PubMed Jacobs EJ, Thun MJ, Connell CJ et al (2005) Aspirin and other nonsteroidal anti-inflammatory drugs and breast cancer incidence in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 14(1):261–264PubMed
66.
go back to reference Zhang Y, Coogan PF, Palmer JR, Strom BL, Rosenberg L (2005) Use of nonsteroidal antiinflammatory drugs and risk of breast cancer: the case–control surveillance study revisited. Am J Epidemiol 162(2):165–170. doi:10.1093/aje/kwi182 PubMedCrossRef Zhang Y, Coogan PF, Palmer JR, Strom BL, Rosenberg L (2005) Use of nonsteroidal antiinflammatory drugs and risk of breast cancer: the case–control surveillance study revisited. Am J Epidemiol 162(2):165–170. doi:10.​1093/​aje/​kwi182 PubMedCrossRef
67.
go back to reference Parrett ML, Harris RE, Joarder FS, Ross MS, Clausen KP, Robertson FM (1997) Cyclooxygenase-2 gene expression in human breast cancer. Int J Oncol 10:503–507 Parrett ML, Harris RE, Joarder FS, Ross MS, Clausen KP, Robertson FM (1997) Cyclooxygenase-2 gene expression in human breast cancer. Int J Oncol 10:503–507
69.
go back to reference Silverstein FE, Faich G, Goldstein JL, Tatham LM, La Vecchia C (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial Celecoxib Long-term Arthritis Safety Study. J Am Med Assoc 284:1247–1255CrossRef Silverstein FE, Faich G, Goldstein JL, Tatham LM, La Vecchia C (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial Celecoxib Long-term Arthritis Safety Study. J Am Med Assoc 284:1247–1255CrossRef
70.
go back to reference Bombardier C, Laine L, Reicin A, Tatham LM, Vecchia CL (2000) Group VIGORS: comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 343:1520–1528PubMedCrossRef Bombardier C, Laine L, Reicin A, Tatham LM, Vecchia CL (2000) Group VIGORS: comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 343:1520–1528PubMedCrossRef
Metadata
Title
Association between NSAIDs use and breast cancer risk: a systematic review and meta-analysis
Authors
Ya-shuang Zhao
Sui Zhu
Xiang-wei Li
Fan Wang
Fu-lan Hu
Dan-dan Li
Wen-cui Zhang
Xia Li
Publication date
01-09-2009
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2009
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-008-0228-6

Other articles of this Issue 1/2009

Breast Cancer Research and Treatment 1/2009 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine