Non-steroidal anti-inflammatory drug and aspirin use and the risk of head and neck cancer: a systematic review.
ABSTRACT Use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with a reduced risk of several cancers. This is thought to be through the inhibitory action on the cyclooxygenase (COX) enzyme, COX-2. Evidence for NSAIDs preventing head and neck cancer (HNC) is conflicting. We conducted a systematic literature review to investigate the association between NSAID/aspirin use and risk of head and neck cancer (HNC).
MEDLINE, EMBASE, PubMed, Cochrane Library, and Web of Science were systematically searched using terms for NSAIDs/aspirin, HNC, and observational/intervention study designs to identify studies published by December 2009.
Of 9,268 articles identified, two population-based prescribing database studies and three case-control studies met the selection criteria. The studies investigated different HNC sites. Only one study found a significant protective association of aspirin use with HNC risk (OR 0.75, 95% CI 0.58-0.96), and one showed a significantly increased risk of oral/oropharyngeal cancer with non-low-dose aspirin NSAID use (OR 3.5, 95% CI 1.8-6.7). Many of the studies identified lacked information on important confounding factors.
No definitive conclusion on the effect of NSAIDs/aspirin on HNC risk was possible. Aspirin may protect against HNC, although further robust large-scale studies are required to clarify any possible association.
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ABSTRACT: The potential of salicylic acid (SA) encapsulated in porous materials as drug delivery carriers for cancer treatment was studied. Different porous structures, the microporous zeolite NaY, and the mesoporous SBA-15 and MCM-41 were used as hosts for the anti-inflammatory drug. Characterization with different techniques (FTIR, UV/vis, TGA, 1 H NMR, and 13 C CPMAS NMR) demonstrated the successful loading of SA into the porous hosts. The mesoporous structures showed to be very efficient to encapsulate the SA molecule. The obtained drug delivery systems (DDS) accommodated 0.74 mmol (341 mg/g ZEO) in NaY and 1.07 mmol (493 mg/g ZEO) to 1.23 mmol (566 mg/g ZEO) for SBA-15 and MCM-41, respectively. Interactions between SA molecules and pore structures were identified. A fast and unrestricted liberation of SA at 10 min of the dissolution assay was achieved with 29.3, 46.6, and 50.1 μg/mL of SA from NaY, SBA-15, and MCM-41, respectively, in the in vitro drug release studies (PBS buffer pH 7.4, 37 °C). Kinetic modeling was used to determine the release patterns of the DDS. The porous structures and DDS were evaluated on Hs578T and MDA-MB-468 breast cancer cell lines viability. The porous structures are nontoxic to cancer cells. Cell viability reduction was only observed after the release of SA from MCM-41 followed by SBA-15 in both breast cancer cell lines.The Journal of Physical Chemistry C 02/2015; 119(7):3589-3595. DOI:10.1021/jp5117849 · 4.84 Impact Factor
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ABSTRACT: Background: Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are widely used as analgesics and preventative agents for vascular events. It is unclear whether their long-term use affects cancer risk. Data on the chemopreventative role of these drugs on the risk of the upper aerodigestive tract cancer (UADT) are insufficient and mostly refer to oesophageal cancer. The aim of this study was to investigate the effect of aspirin and other NSAIDs on the risk of UADT cancers. Methods: A nested case-control study using the Primary Care Clinical Informatics Unit (PCCIU) database. Conditional logistics regression was used for data analysis. Results: There were 2392 cases of UADT cancer diagnosed between 1996 and 2010 and 7165 age-, gender-and medical practice-matched controls from 131 general medical practices. Mean age of cases was 66 years (s.d. 12) and most were male (63%). Aspirin was prescribed in a quarter of cases and controls, COX-2 inhibitors in 4% of cases and 5% of controls and other NSAIDs in 33% of cases and 36% of controls. Aspirin prescription was associated with a nonsignificant risk reduction of cancer of UADT (adjusted OR = 0.9, 95% CI = 0.8, 1.0), head and neck (HN; adjusted OR = 0.9, 95% CI = 0.7, 1.1) or the oesophagus (adjusted OR = 0.8, 95% CI = 0.7, 1.0). Similar results were found for COX-2 inhibitors prescription. Prescription of other NSAIDs was associated with significantly reduced risk of cancer of UADT (adjusted OR = 0.8, 95% CI = 0.7, 0.9), HN (adjusted OR = 0.8, 95% CI = 0.7, 0.9) and the oesophagus (adjusted OR = 0.8, 95% CI = 0.7, 0.9). An increased volume of aspirin prescriptions was associated with a significant risk reduction (test for trend P<0.001). Conclusions: The decreased risk of cancer of the UADT associated with the use of non-COX-2 inhibitors, NSAIDs and long-term aspirin therapy warrants further exploration of the benefits vs risks of the use of these agents.British Journal of Cancer 09/2014; 111(9). DOI:10.1038/bjc.2014.473 · 4.82 Impact Factor
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ABSTRACT: Chronic inflammation has been linked to cancers, and use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risk of several cancers. To further refine the magnitude of NSAID-related associations, in particular for cancers related to inflammation, such as alcohol-, infection-, obesity-, and smoking-related cancers, as well as for less common cancers, we evaluated the use of NSAIDs and cancer risk in a very large cohort. We used propensity scores to account for potential selection bias and hypothesized that NSAID use is associated with decreased cancer incidence. We conducted a prospective study among 314,522 participants in the NIH-AARP Diet and Health Study. Individuals who completed the lifestyle questionnaire, which included NSAID use, in 1996-1997 were followed through 2006. Information on cancer incidence was ascertained by linking to cancer registries and vital status databases. During 2,715,994 person-years of follow-up (median 10.1 person-years), there were 51,894 incident cancers. Compared with non-users of NSAIDs, individuals who reported use in the 12 months prior to interview had a significantly lower risk of all inflammation-related cancer, alcohol-related, infection-related, obesity-related, and smoking-related cancers [hazard ratio (HR) (95% CI)) 0.90 (0.87-0.93), 0.80 (0.74-0.85), 0.82 (0.78-0.87), 0.88 (0.84-0.92), and 0.88 (0.85-0.92) respectively)]. After accounting for potential selection bias, our data showed an inverse association between NSAID use and alcohol-related, infection-related, obesity-related, and smoking-related cancers and support the hypothesis that inflammation is related to an increased risk of certain cancers.PLoS ONE 12/2014; 9(12):e114633. DOI:10.1371/journal.pone.0114633 · 3.53 Impact Factor