Use of aspirin, but not other non-steroidal anti-inflammatory drugs is associated with decreased prostate cancer risk at the population level

Overview

There has been increasing evidence that prostate cancer cells depend on the enzyme cyclooxygenase 2 (COX-2). It is proposed that interference with this enzyme by aspirin might reduce the risk of prostate cancer or reduce prostate cancer growth. This study was designed to evaluate the impact of these medications on the risk of prostate cancer. The authors conclude that aspirin appeared to be protective against the development of prostate cancer.

Methodology

The authors reviewed all patients in Finland who were diagnosed with prostate cancer between 1995 and 2002, and compared them with patients who were not diagnosed with prostate cancer. They then evaluated both sets of patients to determine which patients had been prescribed COX-2 inhibitors, aspirin, or other NSAIDs, and how much of those medications the patients were estimated to have taken. The drugs analyzed included: aspirin, COX-2 inhibitors (celecoxib [Celebrex®] and rofecoxib [Vioxx®]), and other NSAIDs (such as ibuprofen and naproxen).

Results

  • Patients with prostate cancer were more likely to have taken NSAIDs other than aspirin before diagnosis.

  • Patients without prostate cancer were more likely to have taken aspirin.

  • This data implied, but did not prove, that other NSAIDs may be associated with an increased risk of prostate cancer and that aspirin may be associated with a reduced risk.

Conclusions

  • Aspirin may protect against the development of prostate cancer. This trial suggests that aspirin is associated with a reduced risk of prostate cancer. In contrast, other NSAIDs may be associated with an increased risk of prostate cancer. However, due to the study design, it is hard to prove this conclusion. More studies are necessary to evaluate the potential benefit of aspirin to prevent prostate cancer.