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Nonsteroidal anti-inflammatory drugs do not appear to protect against development of lung cancer

Evidence that use of nonsteroidal anti-inflammatory drugs (NSAIDs) might be associated with decreased risk of colon cancer has raised hope that they might prevent other cancers. However, a new State-wide study of the Tennessee Medicaid (TennCare) population found that NSAIDs did not protect against lung cancer. Researchers at the Vanderbilt Center for Education and Research on Therapeutics examined the relationship between NSAID use and subsequent lung cancer development. They identified lung cancer cases from the TennCare database and randomly selected age-and sex-matched controls. A pharmacy database identified NSAID use during the 5 years prior to cancer diagnosis.

During followup for a median of 6.3 years per person, 3,370 lung cancer cases were identified among the 303,399 persons enrolled in the study. The odds of developing lung cancer among those who had ever used NSAIDs were no different than those who had never used them. There was no difference even among those who had used NSAIDs for more than 2 years in the 5 years prior to lung cancer diagnosis. Thus, there was no protective effect demonstrated for any level of NSAID use. Similar results were found among the 2,519 individuals with chronic obstructive pulmonary disease, who have a higher risk of developing lung cancer.

Although the pharmacy database was an accurate measure of prescription NSAID dispensing, it provided no information on prescription compliance or use of nonprescription NSAIDs. However, most patients in the Medicaid population are reluctant to pay for over-the-counter NSAIDs on an ongoing basis, because prescription NSAIDs are free. Another study limitation was the lack of information about patients' use of tobacco, an important risk factor for developing lung cancer. Thus, smoking status may have confounded the relationship between NSAID use and lung cancer.

The study was supported in part by the Agency for Healthcare Research and Quality (HS10384).

See "Nonsteroidal anti-inflammatory drugs and lung cancer risk: A population-based case control study," by Richard J. Wall, M.D., M.P.H., Yu Shyr, Ph.D., and Walter Smalley, M.D., M.P.H., in the February 2007 Journal of Thoracic Oncology 2(2), pp. 109-114.

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