Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma

Vikrant V. Sahasrabuddhe, Munira Z. Gunja, Barry I. Graubard, Britton Trabert, Lauren M. Schwartz, Yikyung Park, Albert R. Hollenbeck, Neal D. Freedman, Katherine A. Mcglynn

Research output: Contribution to journalArticle

130 Scopus citations

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce chronic inflammation and risk of many cancers, but their effect on risk of hepatocellular carcinoma (HCC) and death due to chronic liver disease (CLD) has not been investigated. Methods: We analyzed prospective data on 300504 men and women aged 50 to 71 years in the National Institutes of Health-AARP Diet and Health Study cohort and linked self-reported aspirin and nonaspirin NSAID use with registry-confirmed diagnoses of HCC (n=250) and death due to CLD (n=428, excluding HCC). We calculated hazard rate ratios (RRs) and their two-sided 95% confidence intervals (CIs) using Cox proportional hazard regression models with adjustment for age, sex, race/ethnicity, cigarette smoking, alcohol consumption, diabetes, and body mass index. All tests of statistical significance were two-sided. Results: Aspirin users had statistically significant reduced risks of incidence of HCC (RR = 0.59; 95% CI = 0.45 to 0.77) and mortality due to CLD (RR = 0.55; 95% CI = 0.45 to 0.67) compared to those who did not use aspirin. In contrast, users of nonaspirin NSAIDs had a reduced risk of mortality due to CLD (RR = 0.74; 95% CI = 0.61 to 0.90) but did not have lower risk of incidence of HCC (RR = 1.08; 95% CI = 0.84 to 1.39) compared to those who did not use nonaspirin NSAIDs. The risk estimates did not vary in statistical significance by frequency (monthly, weekly, daily) of aspirin use, but the reduced risk of mortality due to CLD was statistically significant only among monthly users of nonaspirin NSAIDs compared to non-users. Conclusions: Aspirin use was associated with reduced risk of developing HCC and of death due to CLD whereas nonaspirin NSAID use was only associated with reduced risk of death due to CLD.

Original languageEnglish
Pages (from-to)1808-1814
Number of pages7
JournalJournal of the National Cancer Institute
Volume104
Issue number23
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

Fingerprint Dive into the research topics of 'Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma'. Together they form a unique fingerprint.

  • Cite this

    Sahasrabuddhe, V. V., Gunja, M. Z., Graubard, B. I., Trabert, B., Schwartz, L. M., Park, Y., Hollenbeck, A. R., Freedman, N. D., & Mcglynn, K. A. (2012). Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma. Journal of the National Cancer Institute, 104(23), 1808-1814. https://doi.org/10.1093/jnci/djs452