Pancreatic cancer is associated with long term use of aspirin
David Spurgeon
Women who regularly use aspirin over a long period may be increasing their risk of having pancreatic cancer, says an 18 year study of almost 90 000 women in the United States taking part in the nurses’ health study.
The authors, led by Dr Eva Schernhammer, of Brigham and Women’s Hospital and Harvard Medical School, conclude that their findings contradict other research indicating that analgesics reduce the risk of pancreatic cancer and instead point to an increasing risk that rises with dose ( Journal of the National Cancer Institute 2003;96:22-8). During the 18 years of follow up 161 new cases of pancreatic cancer developed among the 88 378 women studied. Overall, there was no significant difference in risk between women who did take aspirin and those who did not. But when the investigators examined data on the duration of use, they found that the risk of pancreatic cancer among women who took more than two tablets a week over 20 years was 58% higher than the risk among women who did not regularly take aspirin (relative risk 1.58 (95% confidence interval 1.03 to 2.43)). This difference rose to 86% among women who took 14 or more tablets a week (1.86 (1.03 to 3.35)).
The relative risk was 1.11 (95% confidence interval 0.70 to 1.76) for women taking one to three tablets a week, 1.29 (0.70 to 2.40) for those taking four to six tablets, and 1.41 (0.76 to 2.61) for those taking seven to 13 tablets (P for trend 0.02).
In an accompanying editorial Dr John Baron, of Dartmouth Medical School, wrote: "There are no easy answers to the question of what aspirin and other NSAIDs [non-steroidal anti-inflammatory drugs] do to pancreatic carcinogenesis. The findings by Schernhammer et al are provocative and force us to think carefully about the actions of aspirin and other NSAIDs and the mechanisms underlying pancreatic cancer."
