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Use of nonaspirin nonsteroidal anti‐inflammatory drugs and risk of head and neck cancer: A nationwide case–control study
Author(s) -
Cour Cecilie D.,
Dehlendorff Christian,
Aalborg Gitte L.,
Buchwald Christian,
Friis Søren,
Verdoodt Freija,
Kjaer Susanne K.
Publication year - 2019
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.32544
Subject(s) - medicine , odds ratio , confidence interval , population , case control study , confounding , head and neck cancer , relative risk , cancer , risk factor , environmental health
Head and neck cancer (HNC) is the sixth most frequent malignancy with high mortality and substantial morbidity and hence there is a need for identification of preventive factors. Preclinical and observational studies have reported antineoplastic effects of nonaspirin nonsteroidal anti‐inflammatory drugs (NSAIDs), but studies of nonaspirin NSAID use and risk of HNC are sparse and with inconsistent results. We therefore conducted a register‐based case–control study nested in the entire Danish population. Cases ( n = 12,389) comprised all Danish residents aged 30–84 years with a histologically verified primary HNC diagnosis during 2000–2015. Based on the literature, cases were categorized into four groups of anticipated association with human papillomavirus (HPV): strong, potential, no/weak and uncertain. Age‐ and sex‐matched population controls ( n = 185,835) were selected by risk‐set‐sampling. We obtained information on filled prescriptions of nonaspirin NSAIDs, other drug use, comorbid conditions and socioeconomic parameters from nationwide Danish registries. Ever‐use (≥2 prescriptions) of nonaspirin NSAIDs was not associated with the overall risk of HNC after adjustment for potential confounders (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.95–1.03). However, long‐term consistent use (≥5 years) was associated with a 25% reduction in HNC risk (OR: 0.75, 95% CI: 0.62–0.90). Stratified analyses by anticipated HPV‐association showed no material differences in estimates. In conclusion, ever‐use of nonaspirin NSAIDs was not associated with the risk of HNC with no apparent influence on the estimates by the anticipated HPV‐association. However, long‐term consistent use may be associated with a reduced risk of HNC and merits further investigation.