Non-aspirin NSAID use may be associated with fatal renal cell carcinoma
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Current and extended durations of non-aspirin use appeared associated with an increased risk for fatal renal cell carcinoma, according to study results.
The findings, presented during American Association for Cancer Research Annual Meeting, showed prediagnostic acetaminophen use specifically among men positively correlated with fatal renal cell carcinoma.
Rationale and methods
“Data have demonstrated an association between the and an increased risk for renal cell carcinoma, while other data have not demonstrated a relationship,” Rebecca E. Graff, ScD, assistant professor in the department of epidemiology and biostatistics at University of California, San Francisco, told Healio. “We had the opportunity to further explore the potential association in three prospective cohorts with longitudinal data on the use of aspirin, non-aspirin NSAIDs and acetaminophen. Given that these analgesics are the most consumed over-the-counter drugs worldwide, it is important that we understand all their risks and benefits.”
Researchers assessed the association between prediagnostic analgesic use and incidence of total and fatal renal cell carcinoma among individuals included in the Health Professionals Follow-up Study 19862016, Nurses Health Study 1980201 for aspirin 19902016 for non-aspirin NSAIDs and acetaminophen and Nurses Health Study 2 19892015.
They used Cox proportional hazards models to estimate cohort-specific, multivariable HRs and 95% CIs according to current use and duration of use.
Key findings
Overall, researchers identified 796 incident cases of renal cell carcinoma
Metanalyses of the Health Professionals Follow-up Study and Nurses Health Study covariate-adjusted positive associations with current use (HR = 1.37; 95% CI, 0.96-1.96) and duration of use (HR = 2.62; 95% CI, 1.23-5.58) of prediagnostic non-aspirin NSAIDs.
In the Health Professionals Follow-up Study only, researchers found positive associations with current use (HR = 2.35; 95% CI, 1.33-4.17) and duration of use (HR = 1.83; 95% CI, 0.42-7.93) of prediagnostic acetaminophen.
Regarding renal cell carcinoma-specific mortality among those diagnosed with renal cell carcinoma, researchers observed an inverse association with current postdiagnostic aspirin use (HR = 0.68; 95% CI, 0.48-0.97) but not duration of postdiagnostic aspirin use (HR = 0.89; 95% CI, 0.53-1.51).
Of note, analgesics not otherwise associated with renal cell carcinoma survival, according to the researchers.
Implications
“Analgesics may operate differently in the setting of renal cell carcinoma from the context of other chronic diseases. Considerable evidence suggests a beneficial effect of analgesics and especially aspirin on cardiovascular disease and . t is important that patients understand the risks and benefits,” Graff said.
The researchers have plans for additional analyses that will further examine the current findings.
“For example, are the associations only relevant for subtypes of renal cell carcinoma and do associations vary by analgesic dosage? We will compile the sum of our results into a manuscript that we will submit for future publication,” Graff said.
For more information:
Rebecca E. Graff, ScD, can be reached at University of California, San Francisco, Mission Hall: Global Health & Sciences Building, 550 16th St, 2nd Floor, Box #0560, San Francisco, CA 94158; email: rebecca.graff@ucsf.edu.
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Graff RE, et al. Abstract 5893. Presented at: American Association for Cancer Research Annual Meeting (hybrid meeting); April 8-13, 2022.
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