Skip to main content
Top
Published in: International Urology and Nephrology 9/2014

01-09-2014 | Urology - Original Paper

Aspirin use and the risk of prostate cancer: a meta-analysis of 24 epidemiologic studies

Authors: Tian-bao Huang, Yang Yan, Zhui-feng Guo, Xiao-long Zhang, Huan Liu, Jiang Geng, Xu-dong Yao, Jun-hua Zheng

Published in: International Urology and Nephrology | Issue 9/2014

Login to get access

Abstract

Purpose

Several epidemiologic studies were performed to clarify the protective effect of regular aspirin use on prostate cancer risk; however, the results remain controversial. Therefore, we conducted this meta-analysis to assess the association between regular aspirin use and risk of prostate cancer.

Methods

Electronic databases including PubMed, EMBASE and Cochrane Library were searched between January 1966 and April 2013 to identify eligible studies. Pooled relative ratios (RRs) and 95 % confidence intervals (CIs) were computed to assess the influence of aspirin use on prostate cancer risk. All statistical tests were two-sided.

Results

A total of 24 observational studies including 14 case–control studies and 10 cohort studies were eligible for this meta-analysis. Regular aspirin use was associated with reduction in overall and advanced prostate cancer risk (pooled RR 0.86, 95 % CI 0.81–0.92; pooled RR 0.83, 95 % CI 0.75–0.91, respectively). When we restricted our analyses to studies with long-time regular aspirin use (equal or more than 4 years), reverse association became stronger (pooled RR 0.82, 95 % CI 0.72–0.93; pooled RR 0.70, 95 % CI 0.55–0.90, respectively).

Conclusions

Our findings suggest that regular, especially long-time regular aspirin use may reduce the risk of overall and advanced prostate cancer. Considering the limitation of included studies, further well-designed large-scaled cohort studies and RCTs are required to draw more definitive conclusions.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Sabichi AL, Lippman SM (2004) COX-2 inhibitors and other nonsteroidal anti-inflammatory drugs in genitourinary cancer. Semin Oncol 31:36–44PubMedCrossRef Sabichi AL, Lippman SM (2004) COX-2 inhibitors and other nonsteroidal anti-inflammatory drugs in genitourinary cancer. Semin Oncol 31:36–44PubMedCrossRef
3.
go back to reference Zha S, Yegnasubramanian V, Nelson WG, Isaacs WB, De Marzo AM (2004) Cyclooxygenases in cancer: progress and perspective. Cancer Lett 215:1–20PubMedCrossRef Zha S, Yegnasubramanian V, Nelson WG, Isaacs WB, De Marzo AM (2004) Cyclooxygenases in cancer: progress and perspective. Cancer Lett 215:1–20PubMedCrossRef
4.
go back to reference Bosetti C, Gallus S, La Vecchia C (2006) Aspirin and cancer risk: an updated quantitative review to 2005. Cancer Causes Control 17:871–888PubMedCrossRef Bosetti C, Gallus S, La Vecchia C (2006) Aspirin and cancer risk: an updated quantitative review to 2005. Cancer Causes Control 17:871–888PubMedCrossRef
5.
go back to reference Mahmud SM, Franco EL, Aprikian AG (2010) Use of nonsteroidal anti-inflammatory drugs and prostate cancer risk: a meta-analysis. Int J Cancer 127:1680–1691PubMedCrossRef Mahmud SM, Franco EL, Aprikian AG (2010) Use of nonsteroidal anti-inflammatory drugs and prostate cancer risk: a meta-analysis. Int J Cancer 127:1680–1691PubMedCrossRef
6.
go back to reference Bosetti C, Rosato V, Gallus S, La Vecchia C (2012) Aspirin and urologic cancer risk: an update. Nat Rev Urol. 9:102–110PubMedCrossRef Bosetti C, Rosato V, Gallus S, La Vecchia C (2012) Aspirin and urologic cancer risk: an update. Nat Rev Urol. 9:102–110PubMedCrossRef
7.
go back to reference Shebl FM, Sakoda LC, Black A et al (2012) Aspirin but not ibuprofen use is associated with reduced risk of prostate cancer: a PLCO study. Br J Cancer 107:207–214PubMedCentralPubMedCrossRef Shebl FM, Sakoda LC, Black A et al (2012) Aspirin but not ibuprofen use is associated with reduced risk of prostate cancer: a PLCO study. Br J Cancer 107:207–214PubMedCentralPubMedCrossRef
8.
go back to reference Dhillon PK, Kenfield SA, Stampfer MJ, Giovannucci EL (2011) Long-term aspirin use and the risk of total, high-grade, regionally advanced and lethal prostate cancer in a prospective cohort of health professionals, 1988–2006. Int J Cancer 128:2444–2452PubMedCentralPubMedCrossRef Dhillon PK, Kenfield SA, Stampfer MJ, Giovannucci EL (2011) Long-term aspirin use and the risk of total, high-grade, regionally advanced and lethal prostate cancer in a prospective cohort of health professionals, 1988–2006. Int J Cancer 128:2444–2452PubMedCentralPubMedCrossRef
9.
go back to reference Veitonmaki T, Tammela TL, Auvinen A, Murtola TJ (2013) Use of aspirin, but not other non-steroidal anti-inflammatory drugs is associated with decreased prostate cancer risk at the population level. Eur J Cancer 49:938–945PubMedCrossRef Veitonmaki T, Tammela TL, Auvinen A, Murtola TJ (2013) Use of aspirin, but not other non-steroidal anti-inflammatory drugs is associated with decreased prostate cancer risk at the population level. Eur J Cancer 49:938–945PubMedCrossRef
10.
go back to reference Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012PubMedCrossRef Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012PubMedCrossRef
11.
go back to reference Ratnasinghe LD, Graubard BI, Kahle L, Tangrea JA, Taylor PR, Hawk E (2004) Aspirin use and mortality from cancer in a prospective cohort study. Anticancer Res 24:3177–3184PubMed Ratnasinghe LD, Graubard BI, Kahle L, Tangrea JA, Taylor PR, Hawk E (2004) Aspirin use and mortality from cancer in a prospective cohort study. Anticancer Res 24:3177–3184PubMed
12.
go back to reference Thun MJ, Namboodiri MM, Calle EE, Flanders WD, Heath CW Jr (1993) Aspirin use and risk of fatal cancer. Cancer Res 53:1322–1327PubMed Thun MJ, Namboodiri MM, Calle EE, Flanders WD, Heath CW Jr (1993) Aspirin use and risk of fatal cancer. Cancer Res 53:1322–1327PubMed
13.
go back to reference Leitzmann MF, Stampfer MJ, Ma J et al (2002) Aspirin use in relation to risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 11:1108–1111PubMed Leitzmann MF, Stampfer MJ, Ma J et al (2002) Aspirin use in relation to risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 11:1108–1111PubMed
14.
go back to reference Garcia Rodriguez LA, Gonzalez-Perez A (2004) Inverse association between nonsteroidal anti-inflammatory drugs and prostate cancer. Cancer Epidemiol Biomarkers Prev 13:649–653PubMed Garcia Rodriguez LA, Gonzalez-Perez A (2004) Inverse association between nonsteroidal anti-inflammatory drugs and prostate cancer. Cancer Epidemiol Biomarkers Prev 13:649–653PubMed
15.
go back to reference Dasgupta K, Di Cesar D, Ghosn J, Rajan R, Mahmud S, Rahme E (2006) Association between nonsteroidal anti-inflammatory drugs and prostate cancer occurrence. Cancer J 12:130–135PubMed Dasgupta K, Di Cesar D, Ghosn J, Rajan R, Mahmud S, Rahme E (2006) Association between nonsteroidal anti-inflammatory drugs and prostate cancer occurrence. Cancer J 12:130–135PubMed
16.
go back to reference Murad AS, Down L, Davey Smith G et al (2011) Associations of aspirin, nonsteroidal anti-inflammatory drug and paracetamol use with PSA-detected prostate cancer: findings from a large, population-based, case–control study (the ProtecT study). Int J Cancer 128:1442–1448PubMedCrossRef Murad AS, Down L, Davey Smith G et al (2011) Associations of aspirin, nonsteroidal anti-inflammatory drug and paracetamol use with PSA-detected prostate cancer: findings from a large, population-based, case–control study (the ProtecT study). Int J Cancer 128:1442–1448PubMedCrossRef
17.
go back to reference Mahmud SM, Franco EL, Turner D et al (2011) Use of non-steroidal anti-inflammatory drugs and prostate cancer risk: a population-based nested case–control study. PLoS One 6:e16412PubMedCentralPubMedCrossRef Mahmud SM, Franco EL, Turner D et al (2011) Use of non-steroidal anti-inflammatory drugs and prostate cancer risk: a population-based nested case–control study. PLoS One 6:e16412PubMedCentralPubMedCrossRef
18.
go back to reference Norrish AE, Jackson RT, McRae CU (1998) Non-steroidal anti-inflammatory drugs and prostate cancer progression. Int J Cancer 77:511–515PubMedCrossRef Norrish AE, Jackson RT, McRae CU (1998) Non-steroidal anti-inflammatory drugs and prostate cancer progression. Int J Cancer 77:511–515PubMedCrossRef
19.
go back to reference Irani J, Ravery V, Pariente JL et al (2002) Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk. J Urol 168:1985–1988PubMedCrossRef Irani J, Ravery V, Pariente JL et al (2002) Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk. J Urol 168:1985–1988PubMedCrossRef
20.
go back to reference Perron L, Bairati I, Moore L, Meyer F (2003) Dosage, duration and timing of nonsteroidal antiinflammatory drug use and risk of prostate cancer. Int J Cancer 106:409–415PubMedCrossRef Perron L, Bairati I, Moore L, Meyer F (2003) Dosage, duration and timing of nonsteroidal antiinflammatory drug use and risk of prostate cancer. Int J Cancer 106:409–415PubMedCrossRef
21.
go back to reference Liu X, Plummer SJ, Nock NL, Casey G, Witte JS (2006) Nonsteroidal antiinflammatory drugs and decreased risk of advanced prostate cancer: modification by lymphotoxin alpha. Am J Epidemiol 164:984–989PubMedCrossRef Liu X, Plummer SJ, Nock NL, Casey G, Witte JS (2006) Nonsteroidal antiinflammatory drugs and decreased risk of advanced prostate cancer: modification by lymphotoxin alpha. Am J Epidemiol 164:984–989PubMedCrossRef
22.
go back to reference Salinas CA, Kwon EM, FitzGerald LM et al (2010) Use of aspirin and other nonsteroidal antiinflammatory medications in relation to prostate cancer risk. Am J Epidemiol 172:578–590PubMedCentralPubMedCrossRef Salinas CA, Kwon EM, FitzGerald LM et al (2010) Use of aspirin and other nonsteroidal antiinflammatory medications in relation to prostate cancer risk. Am J Epidemiol 172:578–590PubMedCentralPubMedCrossRef
23.
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 7:869–873PubMed 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 7:869–873PubMed
24.
go back to reference Bosetti C, Talamini R, Negri E, Franceschi S, Montella M, La Vecchia C (2006) Aspirin and the risk of prostate cancer. Eur J Cancer Prev 15:43–45PubMedCrossRef Bosetti C, Talamini R, Negri E, Franceschi S, Montella M, La Vecchia C (2006) Aspirin and the risk of prostate cancer. Eur J Cancer Prev 15:43–45PubMedCrossRef
25.
go back to reference Menezes RJ, Swede H, Niles R, Moysich KB (2006) Regular use of aspirin and prostate cancer risk (United States). Cancer Causes Control 17:251–256PubMedCrossRef Menezes RJ, Swede H, Niles R, Moysich KB (2006) Regular use of aspirin and prostate cancer risk (United States). Cancer Causes Control 17:251–256PubMedCrossRef
27.
go back to reference Schreinemachers DM, Everson RB (1994) Aspirin use and lung, colon, and breast cancer incidence in a prospective study. Epidemiology 5:138–146PubMedCrossRef Schreinemachers DM, Everson RB (1994) Aspirin use and lung, colon, and breast cancer incidence in a prospective study. Epidemiology 5:138–146PubMedCrossRef
28.
go back to reference Habel LA, Zhao W, Stanford JL (2002) Daily aspirin use and prostate cancer risk in a large, multiracial cohort in the US. Cancer Causes Control 13:427–434PubMedCrossRef Habel LA, Zhao W, Stanford JL (2002) Daily aspirin use and prostate cancer risk in a large, multiracial cohort in the US. Cancer Causes Control 13:427–434PubMedCrossRef
29.
go back to reference Platz EA, Rohrmann S, Pearson JD et al (2005) Nonsteroidal anti-inflammatory drugs and risk of prostate cancer in the Baltimore Longitudinal Study of Aging. Cancer Epidemiol Biomark Prev 14:390–396CrossRef Platz EA, Rohrmann S, Pearson JD et al (2005) Nonsteroidal anti-inflammatory drugs and risk of prostate cancer in the Baltimore Longitudinal Study of Aging. Cancer Epidemiol Biomark Prev 14:390–396CrossRef
30.
go back to reference Jacobs EJ, Thun MJ, Bain EB, 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 EB, 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
31.
go back to reference Brasky TM, Velicer CM, Kristal AR, Peters U, Potter JD, White E (2010) Nonsteroidal anti-inflammatory drugs and prostate cancer risk in the vitamins and lifestyle (VITAL) cohort. Cancer Epidemiol Biomark Prev 19:3185–3188CrossRef Brasky TM, Velicer CM, Kristal AR, Peters U, Potter JD, White E (2010) Nonsteroidal anti-inflammatory drugs and prostate cancer risk in the vitamins and lifestyle (VITAL) cohort. Cancer Epidemiol Biomark Prev 19:3185–3188CrossRef
32.
go back to reference Siemes C, Visser LE, Coebergh JW, Hofman A, Uitterlinden AG, Stricker BH (2008) Protective effect of NSAIDs on cancer and influence of COX-2 C(-765G) genotype. Curr Cancer Drug Targets 8:753–764PubMedCrossRef Siemes C, Visser LE, Coebergh JW, Hofman A, Uitterlinden AG, Stricker BH (2008) Protective effect of NSAIDs on cancer and influence of COX-2 C(-765G) genotype. Curr Cancer Drug Targets 8:753–764PubMedCrossRef
33.
go back to reference Mahmud SM, Tanguay S, Begin LR, Franco EL, Aprikian AG (2006) Non-steroidal anti-inflammatory drug use and prostate cancer in a high-risk population. Eur J Cancer Prev 15:158–164PubMedCrossRef Mahmud SM, Tanguay S, Begin LR, Franco EL, Aprikian AG (2006) Non-steroidal anti-inflammatory drug use and prostate cancer in a high-risk population. Eur J Cancer Prev 15:158–164PubMedCrossRef
34.
go back to reference Jacobs EJ, Rodriguez C, Mondul AM et al (2005) A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence. J Natl Cancer Inst 97:975–980PubMedCrossRef Jacobs EJ, Rodriguez C, Mondul AM et al (2005) A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence. J Natl Cancer Inst 97:975–980PubMedCrossRef
35.
go back to reference Elwood PC, Gallagher AM, Duthie GG, Mur LA, Morgan G (2009) Aspirin, salicylates, and cancer. Lancet 373:1301–1309PubMedCrossRef Elwood PC, Gallagher AM, Duthie GG, Mur LA, Morgan G (2009) Aspirin, salicylates, and cancer. Lancet 373:1301–1309PubMedCrossRef
36.
go back to reference Gupta S, Srivastava M, Ahmad N, Bostwick DG, Mukhtar H (2000) Over-expression of cyclooxygenase-2 in human prostate adenocarcinoma. Prostate 42:73–78PubMedCrossRef Gupta S, Srivastava M, Ahmad N, Bostwick DG, Mukhtar H (2000) Over-expression of cyclooxygenase-2 in human prostate adenocarcinoma. Prostate 42:73–78PubMedCrossRef
37.
go back to reference Kirschenbaum A, Klausner AP, Lee R et al (2000) Expression of cyclooxygenase-1 and cyclooxygenase-2 in the human prostate. Urology 56:671–676PubMedCrossRef Kirschenbaum A, Klausner AP, Lee R et al (2000) Expression of cyclooxygenase-1 and cyclooxygenase-2 in the human prostate. Urology 56:671–676PubMedCrossRef
38.
go back to reference Nithipatikom K, Isbell MA, Lindholm PF, Kajdacsy-Balla A, Kaul S, Campell WB (2002) Requirement of cyclooxygenase-2 expression and prostaglandins for human prostate cancer cell invasion. Clin Exp Metastasis 19:593–601PubMedCrossRef Nithipatikom K, Isbell MA, Lindholm PF, Kajdacsy-Balla A, Kaul S, Campell WB (2002) Requirement of cyclooxygenase-2 expression and prostaglandins for human prostate cancer cell invasion. Clin Exp Metastasis 19:593–601PubMedCrossRef
39.
go back to reference Sawada N, Inoue M, Iwasaki M et al (2014) Alcohol and smoking and subsequent risk of prostate cancer in Japanese men: The Japan Public Health Center-based prospective study. Int J Cancer 134:971–978 Sawada N, Inoue M, Iwasaki M et al (2014) Alcohol and smoking and subsequent risk of prostate cancer in Japanese men: The Japan Public Health Center-based prospective study. Int J Cancer 134:971–978
Metadata
Title
Aspirin use and the risk of prostate cancer: a meta-analysis of 24 epidemiologic studies
Authors
Tian-bao Huang
Yang Yan
Zhui-feng Guo
Xiao-long Zhang
Huan Liu
Jiang Geng
Xu-dong Yao
Jun-hua Zheng
Publication date
01-09-2014
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 9/2014
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-014-0703-4

Other articles of this Issue 9/2014

International Urology and Nephrology 9/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.