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Open Access Highly Access Research article

Prescriptions for selective cyclooxygenase-2 inhibitors, non-selective non-steroidal anti-inflammatory drugs, and risk of breast cancer in a population-based case-control study

Deirdre P Cronin-Fenton1*, Lars Pedersen1, Timothy L Lash1,2, Søren Friis3, John A Baron4 and Henrik T Sørensen1,2

  • * Corresponding author: Deirdre P Cronin-Fenton dc@dce.au.dk

Author Affiliations

1 Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200 Aarhus N, Denmark

2 Department of Epidemiology, School of Public Health, Boston University, 715 Albany Street, TE3, Boston, MA 02118, USA

3 Institute of Cancer Epidemiology, The Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark

4 Departments of Community and Family Medicine and Medicine and the Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA

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Breast Cancer Research 2010, 12:R15 doi:10.1186/bcr2482

Published: 1 March 2010

Abstract

Introduction

Non-steroidal anti-inflammatory drugs (NSAIDs) prevent the growth of mammary tumours in animal models. Two population-based case-control studies suggest a reduced risk of breast cancer associated with selective cyclooxygenase-2 (sCox-2) inhibitor use, but data regarding the association between breast cancer occurrence and use of non-selective NSAIDs are conflicting.

Methods

We conducted a population-based case-control study using Danish healthcare databases to examine if use of NSAIDs, including sCox-2 inhibitors, was associated with a reduced risk of breast cancer. We included 8,195 incident breast cancer cases diagnosed in 1991 through 2006 and 81,950 population controls.

Results

Overall, we found no reduced breast cancer risk in ever users (>2 prescriptions) of sCox-2 inhibitors (odds ratio (OR) = 1.08, 95% confidence interval (95% CI) = 0.99, 1.18), aspirin (OR = 0.98, 95% CI = 0.90-1.07), or non-selective NSAIDs OR = 1.04, (95% CI = 0.98, 1.10)). Recent use (>2 prescriptions within two years of index date) of sCox-2 inhibitors, aspirin, or non-selective NSAIDs was likewise not associated with breast cancer risk (Ors = 1.06 (95% CI = 0.96, 1.18), 0.96 (95% CI = 0.87, 1.06) and 0.99 (95% CI = 0.85, 1.16), respectively). Risk estimates by duration (<10, 10 to 15, 15+ years) or intensity (low/medium/high) of NSAID use were also close to unity. Regardless of intensity, shorter or long-term NSAID use was not significantly associated with breast cancer risk.

Conclusions

Overall, we found no compelling evidence of a reduced risk of breast cancer associated with use of sCox-2 inhibitors, aspirin, or non-selective NSAIDs.