NSAIDs and the risk of head and neck cancer

Assorted pills

Non-steroidal anti-inflammatory drugs (NSAIDs) use  has been associated with a reduced risk of a number of  cancers. The mechanism is thought to be via the inhibitory action on the cyclooxygenase (COX) enzyme, COX-2.  The aim of this review was to investigate the association between NSAID/aspirin use and risk of head and neck cancer (HNC).

The authours conducted searches of  Medline, Embase, PubMed, the Cochrane Library, and Web of Science limited to human studies and excluded review articles. Observational and interventional studies were included  and no language restriction was imposed.

They found  two population-based prescribing database studies and three case–control studies that met  the selection criteria. The studies investigated different HNC sites.

  • one study found a significant protective association of aspirin use with HNC risk (OR 0.75, 95% CI 0.58–0.96),
  • 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.

They concluded

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.

Wilson JC, Anderson LA, Murray LJ, Hughes CM. Non-steroidal anti-inflammatory drug and aspirin use and the risk of head and neck cancer: a systematic review.Cancer Causes Control. 2011 May;22(5):803-10. Epub 2011 Mar 17. PubMed PMID:21409528.

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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