Cancer Res Treat.  2018 Jul;50(3):984-991. 10.4143/crt.2017.248.

Effects of Aspirin, Nonsteroidal Anti-inflammatory Drugs, Statin, and COX2 Inhibitor on the Developments of Urological Malignancies: A Population-Based Study with 10-Year Follow-up Data in Korea

• Kang M
• Ku JH
• Kwak C
• Kim HH
• Jeong CW

• KMID: 2417887
• DOI: http://doi.org/10.4143/crt.2017.248

Abstract

PURPOSE
The purpose of this study was to determine the impact of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), statin, and cyclooxygenase 2 (COX-2) inhibitor on the development of kidney, prostate, and urothelial cancers by analyzing the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database.
MATERIALS AND METHODS
Among a representative sample cohort of 1,025,340 participants in NHIS-NSC database in 2002, we extracted data of 799,850 individuals who visited the hospital more than once, and finally included 321,122 individuals aged 40 and older. Following a 1-year washout period between 2002 and 2003, we analyzed 143,870 (male), 320,861 and 320,613 individuals for evaluating the risk of prostate cancer, kidney cancer and urothelial cancer developments, respectively, during 10-year follow-up periods between 2004 and 2013. The medication group consisted of patients prescribed these drugs more than 60% of the time in 2003. To adjustfor various parameters of the patients, a multivariate Cox regression model was adopted.
RESULTS
During 10-year follow-up periods between 2004 and 2013, 9,627 (6.7%), 1,107 (0.4%), and 2,121 (0.7%) patients were diagnosed with prostate cancer, kidney cancer, and urothelial cancer, respectively. Notably, multivariate analyses revealed that NSAIDs significantly increased the risk of prostate cancer (hazard ratio [HR], 1.35). Also, it was found that aspirin (HR, 1.28) and statin (HR, 1.55) elevated the risk of kidney cancer. No drugs were associated with the risk of urothelial cancer.
CONCLUSION
In sum, our study provides the valuable information for the impact of aspirin, NSAID, statin, and COX-2 inhibitor on the risk of prostate, kidney, and urothelial cancer development and its survival outcomes.

Keyword

National Health Insurance Corporation Database; Prostate neoplasms; Kidney neoplasms; Urothelial cancer; Anti-inflammatory agents

MeSH Terms

Anti-Inflammatory Agents
Anti-Inflammatory Agents, Non-Steroidal
Aspirin*
Cohort Studies
Cyclooxygenase 2
Follow-Up Studies*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors*
Kidney
Kidney Neoplasms
Korea*
Multivariate Analysis
National Health Programs
Prostate
Prostatic Neoplasms
Anti-Inflammatory Agents
Anti-Inflammatory Agents, Non-Steroidal
Aspirin
Cyclooxygenase 2

Figure

• 

  Fig. 1. Kaplan-Meier analysis for estimating the risk of prostate cancer development over 10 years (2003-2013) according to the prescription of nonsteroidal anti-inflammatory drugs (NSAIDs; yes vs. no). Log-rank test was used to define the statistical differences between the two groups.

• 

  Fig. 2. Kaplan-Meier analysis for estimating the risk of kidney cancer development over 10 years (2003-2013) according to the prescription of aspirin (A) and statin (yes vs. no) (B), respectively. Log-rank tests were used to define the statistical differences between the two groups.

Reference

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