Analgesic and anti-inflammatory drug use and risk of bladder cancer: a population based case control study

Joan Fortuny¹ , Manolis Kogevinas¹ , Michael S Zens² , Alan Schned³ , Angeline S Andrew² , John Heaney⁴ , Karl T Kelsey⁵ and Margaret R Karagas²

¹Respiratory and Environmental Health Research Unit. Municipal Institute of Medical Research (IMIM), 08003 Barcelona, Catalonia, Spain

²Department of Community and Family Medicine, Section of Biostatistics and Epidemiology, Dartmouth Medical School, Hanover, NH 03756, USA

³Department of Pathology, Dartmouth Medical School, Hanover, NH 03756, USA

⁴Department of Surgery, Dartmouth Medical School, Hanover, NH 03756, USA

⁵Departments of Community Health and Laboratory Medicine and Pathology, Brown University, PRovidence, RI 02912, USA

author email corresponding author email

BMC Urology 2007, 7:13doi:10.1186/1471-2490-7-13


Published:	10 August 2007

Abstract

Background

Use of phenacetin and other analgesic and non-steroidal anti-inflammatory drugs (NSAIDs) potentially influences bladder cancer incidence, but epidemiologic evidence is limited.

Methods

We analyzed data from 376 incident bladder cancer cases and 463 controls from a population-based case-control study in New Hampshire on whom regular use of analgesic drugs and NSAIDs was obtained. Odds ratios and 95% confidence intervals were computed using logistic regression with adjustment for potentially confounding factors. Separate models by tumor stage, grade and TP53 status were conducted.

Results

We found an elevated odds ratio (OR) associated with reported use of phenacetin-containing medications, especially with longer duration of use (OR _{>8 years}= 3.00, 95% confidence interval (CI) = 1.4–6.5). In contrast, use of paracetamol did not relate overall to risk of bladder cancer. We also found that regular use of any NSAID was associated with a statistically significant decrease in bladder cancer risk (OR = 0.6, 95% CI = 0.4–0.9), and specifically use of aspirin. Further, the association with NSAID use was largely among invasive, high grade and TP53 positive tumors.

Conclusion

While these agents have been investigated in several studies, a number of questions remain regarding the effects of analgesic and NSAID use on risk of bladder cancer.