Aspirin, NSAIDs reduced risk for aggressive prostate cancer

Men with elevated PSA and a negative prostate biopsy who used aspirin and/or other NSAIDs demonstrated a significantly reduced risk for aggressive prostate cancer compared with those who did not use either type of agent, according to study results presented at the American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research.

The study included 6,390 men who had been included in the REDUCE study, which evaluated whether dutasteride (Avodart, GlaxoSmithKline) reduced risk for incident prostate cancer compared with placebo.

All men had PSA between 2.5 ng/mL and 10 ng/mL, as well as a negative prostate biopsy, prior to the study. Half had never used aspirin or NSAIDs, 21% reported using aspirin, 18% used other NSAIDs, and 11% reported using both aspirin and other NSAIDs.

“Our purpose was to examine the effects of anti-inflammatory medication use on prostate cancer diagnosis in a study where biopsies were performed largely independent of PSA screening, because anti-inflammatory drugs can lower PSA levels and thus could cloud the real effects of these drugs on prostate cancer detection,” Adriana Vidal, PhD, assistant professor of surgery in the division of urology at Duke University School of Medicine, said in a press release. “Given that aspirin inhibits enzymes in the inflammation pathway, any decrease in inflammatory infiltration in the prostate epithelium would be enough to lower PSA levels. Therefore, it is key to note that nearly all the men in our study had a prostate biopsy regardless of PSA values.”

Multivariable analysis showed use of aspirin alone was associated with a reduced risk for total prostate cancer (OR=0.81; P=.015). Neither use of NSAIDs alone nor in combination with aspirin was associated with total, low- or high-grade prostate cancer (all P>.08).

Vidal and colleagues indicated they created “a dichotomous variable” that evaluated aspirin and/or NSAID use vs. nonuse.

Multivariable analysis showed use of aspirin and/or NSAIDs was significantly associated with decreased incidence of total prostate cancer (OR=0.87; P=.03) and high-grade prostate cancer (OR=0.83; P=.04). Results showed no association between aspirin and/or NSAID use and low-grade prostate cancer (OR=0.9; P=.15).

Vidal and colleagues stratified results by geographic region, results showed the association between intake and reduced risk for prostate cancer was similar between men in North America and those in Europe (P>.41). Researchers also observed similar trends among men treated with dutasteride and those who received placebo.

“Our data support the hypothesis that anti-inflammatory drugs may have a biological role in arresting prostate cancer development, but this requires formal prospective testing in randomized trials,” Vidal said. “In the meantime, men should discuss with their doctors the benefits and risks of taking these medicines to potentially lower prostate cancer risk.”

For more information:

Vidal A. Abstract #A58. Presented at: AACR International Conference on Frontiers in Cancer Prevention Research; Sept. 28-Oct. 1, 2014; New Orleans.

Disclosure: The study was funded by GlaxoSmithKline and the NIH.