NSAIDs linked with modestly reduced prostate cancer risk
Long-term use of an NSAID is associated with a 15 percent reduced risk of prostate cancer, say US epidemiologists (J Nat Cancer Inst 2005;97:975-80).

Using data from the Cancer Prevention Study II, they estimated the risk of prostate cancer in 70,144 men according to their self-reported use of NSAIDs. They identified total of 4,853 new cases of prostate cancer between 1992 and 2001, making this one of the largest studies of its kind. At the time, aspirin was the only NSAID available over the counter (OTC), so the data do not specifically consider the possible effects of OTC ibuprofen.

The absolute rate of prostate cancer was 1,013 per 100,000 person-years for men not reporting NSAID use compared with 847 per 100,000 person-years in NSAID users. Current high-level use of an NSAID (equivalent to at least 60 tablets per month) was associated with a lower risk of advanced prostate cancer; this was of borderline statistical significance (relative risk, RR, 0.77; CI95% 0.57 - 1.04). Long duration use of any NSAID was also associated with a slightly reduced risk (RR 0.80, CI95% 0.70 - 0.92), again with possibly greater reduction for advanced cancer (RR 0.67, CI95% 0.44 - 1.03). These figures were similar after adjustment for age and testing for prostate specific antigen.

For ibuprofen, there was a significant trend for lower risk associated with increasing use and, overall, the relative risk of prostate cancer in men reporting long duration of ibuprofen use was 0.63 (CI95% 0.38 - 1.04). Aspirin was the only other NSAID specifically associated with a reduced overall risk (RR 0.85, CI95% 0.73 - 0.99).

The authors say it is premature to conclude that reduced risk of prostate cancer is a benefit of using NSAIDs but, because this is such a common condition, any true protective effect could be important.

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