Columbus, OH—For women with type 1 endometrial cancers, taking certain pills for routine pain relief or cardiovascular disease prevention might come at a very high cost.
A study published in the Journal of the National Cancer Institute reports that regular use of OTC nonsteroidal inflammatory drugs (NSAIDs) such as aspirin and ibuprofen is associated with an increased risk of dying in those patients.
In the observational study, researchers from The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and colleagues sought to understand the association between routine NSAID use and the risk of dying from endometrial cancer among a cohort of more than 4,000 patients.
With 550 endometrial carcinoma–specific deaths and 737 recurrences occurring during a median of 5 years of follow-up, results indicate that regular NSAID use was associated with a 66% increased risk of dying from endometrial cancer among women with type 1 endometrial cancers. That type of cancer typically is a less aggressive form of the disease, according to background information in the article.
The association was found to be statistically significant among patients who reported past or current NSAID use at the time of diagnosis. The strongest link, however, was among patients who had used NSAIDs for more than 10 years in the past but had ceased use prior to diagnosis, for a hazard ratio of 2.23.
Use of NSAIDs was not associated with mortality from typically more aggressive type 2 cancers, however, according to study authors.
“There is increasing evidence that chronic inflammation is involved in endometrial cancer and progression and recent data suggests that inhibition of inflammation through NSAID use plays a role,” explained co-lead author Theodore Brasky, PhD. “This study identifies a clear association that merits additional research to help us fully understand the biologic mechanisms behind this phenomenon. Our finding was surprising because it goes against previous studies that suggest NSAIDs can be used to reduce inflammation and reduce the risk of developing or dying from certain cancers, like colorectal cancer.”
A significant limitation of the study was that information about specific dosages and NSAID use after surgery was not available, according to the researchers.
“We are continuing to analyze the biologic mechanisms by which inflammation is related to cancer progression in this specific cohort of patients,” added co-lead author Ashley Felix, PhD.
Co-author David Cohn, MD, called the results “intriguing” and “worthy of further investigation,” adding, “It is important to remember that endometrial cancer patients are far more likely to die of cardiovascular disease than their cancer, so women who take NSAIDs to reduce their risk of heart attack—under the guidance of their physicians— should continue doing so. While these data are interesting, there is not yet enough data to make a public recommendation for or against taking NSAIDS to reduce the risk of cancer-related death.”
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Published January 4, 2017