Non-steroidal anti-inflammatory drug use and prostate cancer in a
high-risk population.

Departments of aOncology bSurgery (Urology) cEpidemiology and
Biostatistics dPathology McGill University, Montreal eDepartment of
Community Health Sciences, University of Manitoba, Winnipeg, Canada.

Animal and laboratory studies suggest that regular use of non-steroidal
anti-inflammatory drugs (NSAIDs) may reduce prostate cancer risk. The
aim of this study was to investigate the association between NSAID use
and prostate cancer in a high-risk population.

We included 1299 men who were referred to our university's prostate
cancer detection clinic for prostate biopsy between January 1999 and
July 2003. Before transrectal ultrasonography and prostate biopsy, all
men completed a self-administered questionnaire that included questions
on drug use in the preceding 5 years.

On average, NSAID users were older than non-users but there was no
significant difference in mean baseline prostate-specific antigen (PSA).
Four hundred and ninety-four (38%) had biopsy-confirmed prostate cancer.
After adjustment for age, family history of prostate cancer and other
potential confounders, use of aspirin was associated with a 42%
reduction in the odds of prostate cancer detection [95% confidence
interval (CI) 0.36-0.91].

Among cases, regular use of NSAIDs was inversely related to the risk of
detection of more poorly differentiated cancers and cancers with higher
percentage core involvement. These findings support other
epidemiological and experimental evidence that suggests that aspirin may
be useful in prostate cancer prevention.

Further observational studies with adequate case definition and exposure
measurements and careful adjustment for detection bias are warranted.

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
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