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NSAIDs linked to lower mortality after colorectal cancer diagnosis

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Women who regularly use nonsteroidal anti-inflammatory drugs (NSAIDs) have better survival after a colorectal cancer (CRC) diagnosis, research indicates.

“A wide body of evidence links use of NSAIDs to a reduced risk of CRC,” Dr. Jason A. Zell, from the University of California, Irvine, and colleagues note in the October 13 online issue of Cancer. Until now, however, “potential survival benefits associated with NSAID use” had not been established.

To investigate, the researchers analyzed data from 621 women in the California Teachers Study, all with a first primary invasive CRC.

Prior to their CRC diagnosis, roughly 64% did not use NSAIDs regularly, 17% used them 1 to 6 days per week prior, and 20% reported daily use. Overall, roughly 17% percent of the cohort had regularly taken NSAIDs for less than 5 years and approximately 18% reported regular use extending back 5 years or more.

Outcomes were tracked from the date of CRC diagnosis until death or December 31, 2005, which yielded a mean follow-up of 3.4 years and a median of 2.8 years.

“Prediagnosis regular NSAID use (defined as 1 to 3 times per week, 4 to 6 times per week, or daily use) was associated with a 42% reduced risk of death from colorectal cancer (HR, 0.58), compared to no regular NSAID use,” Dr. Zell noted in an email to Reuters Health.

In addition, compared with no regular NSAID use, regular pre-diagnosis use was associated with improved overall survival (HR 0.71), and regular use for 5 years or more was associated with improved overall survival (HR 0.55) and CRC-specific survival (HR 0.40) in adjusted analyses.

When patients were analyzed by the site of their cancer, women with colon cancer and at least 5 years of NSAID use prior to diagnosis had a significant reduction in CRC-specific mortality (HR, 0.46) but not overall mortality (HR, 0.65). No such effect was observed in the subset of patients with rectal cancer, however.

“If confirmed in other studies, these findings may have important implications for tertiary cancer prevention,” the researchers note.

“Several NSAID-based colorectal cancer secondary and tertiary prevention clinical trials are already in the late stages of development,” Dr. Zell told Reuters Health. “It is hoped that these new clinical trials will provide definitive recommendations for colorectal cancer risk reduction among colorectal cancer survivors.”

Cancer 2009.