ORLANDONonsteroidal anti-inflammatory drugs (NSAIDs)
confer protection against the common GI cancers, not only against
colon and rectal cancer, which weve known about, but also in
the esophagus and stomach, where the protection was at least as
strong, Michael Langman, MD, said at the Digestive Disease Week
Dr. Langman led a research team at the University of Birmingham in
England in a large Medical Research Council case-control study based
on the Birmingham groups General Practitioner Research Database
(GPRD). This vast resource contains data on all prescriptions written
by general practitioners for 3.6 million people in the United
Kingdom. It also contains information on diagnostic outcomes, and it
extends back 36 months.
Our hypothesis was that if NSAIDs protect against cancer, we
would see less of the disease in people who had many prescriptions
for NSAIDs, Dr. Langman said.
The group examined NSAID prescription rates for cancer patients 13 to
36 months before their diagnosis. The cancers included five
gastrointestinal cancers (esophagus, stomach, pancreas, colon, and
rectum) and four others (bladder, breast, lung, and prostate). There
were 1,156 cancer cases, each matched for age and sex with three controls.
Trends analysis indicated NSAID protection against all gut epithelial
tumors but did not provide evidence of benefit against all cancers.
The findings on the colon and rectum were not new. We had only
had suggestive data regarding the esophagus and stomach until now,
though, Dr. Langman said. This study provides good
evidence that the protection against cancers of the esophagus and
stomach is at least as strong as that conferred in the colon and rectum.
There was no protection shown against either bladder or breast
cancers. With lung cancer, there was the suggestion of a trend
but nothing significant, Dr. Langman said, and the findings on
prostate cancer were similarly insignificant.
Dr. Langman speculated on possible reasons for the protection working
within the gut but not outside it. It may be straightforward
that the NSAID concentration is strongest in the gut and less
elsewhere. Outside the digestive tract, the drugs may be diluted and
thus offer less protection. Or it may be that the other organ systems
are resistant to the protection.