Table 1.
Association between 10-year NSAID use and small cell lung cancer risk in the VITAL cohort (n = 75,546).
| NSAID | SCLC cases (n = 111), n (%) | Non-cases (n = 75,435), n (%) | Minimally-adjusted HR (95% CI)a |
Multivariable-adjusted HR (95% CI)b |
|---|---|---|---|---|
| Aspirin | ||||
| Non-user | 38 (38.00) | 37,657 (53.94) | 1.00 (reference) | 1.00 (reference) |
| Low (<4 d/wk or <4 y) | 22 (22.00) | 16,812 (24.08) | 1.16 (0.66–2.04) | 1.18 (0.66–2.09) |
| High (≥4 d/wk and ≥4 y) | 40 (40.00) | 15,350 (21.99) | 1.66 (1.01–2.72) P-trend = 0.05 |
1.71 (1.01–2.87) P-trend = 0.05 |
| Low-dose aspirin | ||||
| Non-user | 66 (63.46) | 50,960 (71.36) | 1.00 (reference) | 1.00 (reference) |
| Low (<4 d/wk or <4 y) | 17 (16.35) | 11,673 (16.35) | 1.13 (0.63–2.02) | 1.13 (0.63–2.04) |
| High (≥4 d/wk and ≥4 y) | 21 (20.19) | 8779 (12.29) | 1.33 (0.78–2.29) P-trend = 0.29 |
1.34 (0.77–2.32) P-trend = 0.29 |
| Regular-strength aspirin | ||||
| Non-user | 67 (63.21) | 55,191 (75.40) | 1.00 (reference) | 1.00 (reference) |
| Low (<4 d/wk or <4 y) | 15 (14.15) | 9439 (12.90) | 1.32 (0.71–2.45) | 1.32 (0.71–2.44) |
| High (≥4 d/wk and ≥4 y) | 24 (22.64) | 8568 (11.71) | 1.75 (1.05–2.92) P-trend = 0.03 |
1.78 (1.05–3.02) P-trend = 0.03 |
| Non-aspirin NSAIDsc | ||||
| Non-user | 71 (70.30) | 49,748 (68.97) | 1.00 (reference) | 1.00 (reference) |
| Low (<4 d/wk or <4 y) | 23 (22.77) | 17,210 (23.86) | 0.98 (0.59–1.64) | 0.98 (0.58–1.67) |
| High (≥4 d/wk and ≥4 y) | 7 (6.93) | 5171 (7.17) | 1.04 (0.47–2.29) P-trend = 0.97 |
0.98 (0.43–2.21) P-trend = 0.94 |
| Ibuprofen | ||||
| Non-user | 81 (77.88) | 55,145 (75.46) | 1.00 (reference) | 1.00 (reference) |
| Low (<4 d/wk or <4 y) | 17 (16.35) | 13,890 (19.01) | 0.97 (0.54–1.73) | 0.97 (0.54–1.75) |
| High (≥4 d/wk and ≥4 y) | 6 (5.77) | 4044 (5.53) | 1.20 (0.51–2.79) P-trend = 0.80 |
1.13 (0.47–2.68) P-trend = 0.88 |
Abbreviations: HR: hazards ratio; CI: confidence interval; NSAID: non-steroidal anti-inflammatory drug; SCLC: small cell lung cancer.
a
Adjusted for age, sex, pack-years, pack-years squared, years smoked, and use of other NSAIDs.
b
Adjusted for age, sex, race, education, body mass index, pack-years, pack-years squared, years smoked, family history of lung cancer, history of chronic-obstructive pulmonary disease, history of ulcer, migraine or chronic headache, osteoarthritis or chronic joint pain, rheumatoid arthritis, coronary artery disease, and use of other NSAIDs.
c
Includes ibuprofen, naproxen, and COX-2 inhibitors.