Non-aspirin NSAIDs and head and neck cancer mortality in a Danish nationwide cohort study |
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| Affiliation: | 1. Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark;2. Statistics and Data Analysis, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark;3. Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark;4. Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark;5. Department of Gynecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark;1. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK;2. Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK;3. Department of Colorectal Surgery, Cambridge University Hospitals, Cambridge, UK;4. Department of Oncology, The Christie NHS Foundation Trust, School of Medical Sciences, University of Manchester Manchester, UK;5. Department of Oncology, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK;1. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;2. Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, MD, USA;1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA;2. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA;3. Division of Preventive Medicine, Brigham and Women''s Hospital and Harvard Medical School, Boston, MA, USA;4. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA;5. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;6. Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;7. Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;8. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA;9. Department of Global Health, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA;10. Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA;1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China;2. Laboratory for Environmental Toxicology, Anhui Medical University, Hefei , Anhui 230032, China;1. Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;2. Department of Hematology and Medical Oncology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan |
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| Abstract: | BackgroundEvidence suggests that non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) have antineoplastic properties of potential importance for survival of head and neck cancer.MethodsWe conducted a nationwide cohort study including all individuals with primary head and neck squamous cell carcinoma in Denmark during 2000–2016 at age 30–84 years, with no history of cancer (except non-melanoma skin cancer), and alive at 1 year after diagnosis. Nationwide registries provided information on drug use, causes of death and potential confounders, and additional clinical information was obtained for a subpopulation. We conducted Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between post-diagnosis non-aspirin NSAID use (defined as ≥1 filled prescription within first year after diagnosis) and cancer-specific mortality.ResultsAmong 10,770 head and neck cancer 1-year survivors, the HR for cancer-specific mortality with non-aspirin NSAID use was 1.68 at 1 year after diagnosis, but declined and stabilized around 1.15 (95% CI 1.02–1.29) at 2 years after diagnosis. Among 2-year survivors, the HRs for cancer-specific mortality with non-aspirin NSAID use remained slightly increased in analyses stratified by age, sex, stage, and pre-diagnosis non-aspirin NSAID use. Similar results were seen in the subpopulation (n = 1029) with additional clinical information, and among 5-year survivors with additional non-aspirin NSAID exposure assessment.ConclusionIn this nationwide cohort of patients with head and neck cancer, use of non-aspirin NSAIDs was associated with a slightly increased mortality risk, warranting further evaluation. |
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| Keywords: | Head and neck cancer Oropharyngeal cancer Non-steroidal anti-inflammatory drugs Survival Human papillomavirus |
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