Khalaf N, et al. - This study was conducted to investigate the association between regular use of aspirin and/or non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) and the risk of pancreatic cancer. Among participants from several large prospective cohort studies, regular aspirin or non-aspirin NSAID use was not correlated with future risk of pancreatic cancer. An advanced research was required to identify the possible reduction in risk for pancreatic cancer among people with diabetes who regularly use aspirin.

Methods

• Using multivariable-adjusted Cox proportional hazards regression, the researchers evaluated aspirin and non-aspirin NSAID use and risk of pancreatic adenocarcinoma in 141,940 participants from the Health Professionals Follow-up Study and Nurses’ Health Study.
• Several exposure classifications were considered in order to model differing lag times between NSAID exposure and cancer development.
• Furthermore, they performed a nested case–control study of participants from 3 prospective cohorts using conditional logistic regression to assess pre-diagnosis levels of plasma salicylurate, a major metabolite of aspirin, in 396 pancreatic cancer cases and 784 matched individuals without pancreatic cancer (controls).

Results

• A total of 1,122 participants developed pancreatic adenocarcinoma over 4.2 million person-years, in the prospective cohort study.
• Even after considering several latency exposure classifications, use of aspirin or non-aspirin NSAIDs was not associated with pancreatic cancer risk.
• Regular aspirin use was correlated with reduced pancreatic cancer risk among participants with diabetes (relative risk, 0.71; 95% CI, 0.54-0.94), in a pre-planned subgroup analysis.
• Pre-diagnosis levels of salicylurate were not associated with pancreatic cancer risk (odds ratio, 1.08; 95% CI, 0.72-1.61; P_trend 0.81; comparing participants in the highest quintile to those in the lowest quintile of plasma salicylurate), in the nested case-control study.