Aspirin May Lower the Risk for Aggressive Prostate Cancer

NEW ORLEANS — Use of aspirin and/or other non-steroidal anti-inflammatory drugs
(NSAIDs) was associated with a reduced risk for aggressive prostate cancer in men who had
elevated prostate specific antigen (PSA) and a negative biopsy prior to study commencement,
according to data presented at the 13th Annual American Association for Cancer Research
International Conference on Frontiers in Cancer Prevention Research, held Sept. 28-Oct. 1.
“Our purpose was to examine the effects of anti-inflammatory medication use on prostate cancer
diagnosis in a study where biopsies were performed largely independent of PSA screening,
because anti-inflammatory drugs can lower PSA levels and thus could cloud the real effects of
these drugs on prostate cancer detection,” said Adriana Vidal, PhD, assistant professor of surgery
in the Division of Urology at Duke University School of Medicine in Durham, North Carolina.
“Our data support the hypothesis that anti-inflammatory drugs may have a biological role in
arresting prostate cancer development, but this requires formal prospective testing in randomized
trials,” said Vidal. “In the meantime, men should discuss with their doctors the benefits and risks
of taking these medicines to potentially lower prostate cancer risk.
“Given that aspirin inhibits enzymes in the inflammation pathway, any decrease in inflammatory
infiltration in the prostate epithelium would be enough to lower PSA levels,” explained Vidal.
“Therefore, it is key to note that nearly all the men in our study had a prostate biopsy regardless
of PSA values. Importantly, we found anti-inflammatory drugs were associated with lowered
prostate cancer risk, which is consistent with the hypothesis that these agents reduce prostate
cancer risk supporting future clinical trials of anti-inflammatory drugs for prostate cancer
prevention.
“Further, we found that NSAIDs only lower PSA by a small amount, and we predict this would
have no effect on PSA’s ability to predict prostate cancer in these men,” added Vidal.
Participants were from the REDUCE study that tested if dutasteride reduces the risk of incident
prostate cancer. All men had a PSA between 2.5 ng/mL and10 ng/mL, and a biopsy with
negative results for prostate cancer prior to the start of the study.
Of the 6,390 men, 50 percent never used aspirin and/or other NSAIDs, 21 percent were aspirin
users, 18 percent were users of other NSAIDs, and 11 percent used both aspirin and other
NSAIDs.spirin May Lower the Risk for Aggressive Prostate Cancer
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The researchers found that aspirin and/or NSAIDs use lowered the risk for prostate cancer by 14
percent. After adjusting for confounding factors, the researchers found that the use of aspirin
and/or other NSAIDs reduced the risk for overall prostate cancer by 13 percent and the risk of
high-grade prostate cancer by 17 percent, but no association was found with low-grade prostate
cancer alone.
The benefit from aspirin and/or other NSAIDs was found to be similar between participants from
Europe and North America. The results were also similar between those who were in the
dutasteride arm and those in the placebo arm.
This study was funded by GlaxoSmithKline PLC and the National Institutes of Health. Vidal
declares no conflicts of interest.
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