Exposure to cyclooxygenase-2 inhibitors and risk of cancer: nested case–control studies
2011

COX2 Inhibitors and Cancer Risk

Sample size: 88125 publication 10 minutes Evidence: moderate

Author Information

Author(s): Vinogradova Y, Coupland C, Hippisley-Cox J

Primary Institution: University of Nottingham

Hypothesis

Does long-term use of cyclooxygenase-2 (COX2) inhibitors affect cancer risk?

Conclusion

Prolonged use of COX2 inhibitors was associated with an increased risk of breast and haematological cancers and a decreased risk of colorectal cancer.

Supporting Evidence

  • Long-term use of COX2 inhibitors was linked to a 24% increased risk of breast cancer.
  • Users of COX2 inhibitors had a 38% increased risk of haematological malignancies.
  • Long-term use was associated with a 24% reduced risk of colorectal cancer.

Takeaway

Using certain pain medications called COX2 inhibitors for a long time might make you more likely to get breast and blood cancers, but it could help lower the chance of getting colorectal cancer.

Methodology

Nested case-control studies using the QResearch primary care database, analyzing associations of COX2 inhibitor use with cancer risk.

Potential Biases

There may be residual confounding due to unaccounted over-the-counter NSAID use and potential misclassification of COX2 inhibitor use.

Limitations

The study did not adjust for certain cancer risk factors like physical activity and diet, which may lead to residual confounding.

Participant Demographics

The median age at diagnosis was 69 years, with 53% of cases being men.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 1.08–1.42 for breast cancer; 95% CI 1.12–1.69 for haematological malignancies; 95% CI 0.63–0.92 for colorectal cancer.

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/bjc.2011.252

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