NSAIDs May Raise Risk of Fatal Kidney Cancer

Regular use of non-steroidal anti-inflammatory drugs for 10 years or more increased the risk of dying from renal cell carcinoma nearly 4-fold.
Regular use of non-steroidal anti-inflammatory drugs for 10 years or more increased the risk of dying from renal cell carcinoma nearly 4-fold.

Using of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) for at least 4 years is associated with an increased risk fatal renal cell carcinoma (RCC), researchers reported at the 2016 Genitourinary Cancers Symposium in San Francisco.

Mark A. Preston, MD, of Brigham and Women's Hospital in Boston, and colleagues examined the relationship between use of NSAIDs and RCC risk in 2 large prospective cohorts: the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). In the NHS and MPSF, use of aspirin and other NSAIDs was ascertained in 1990 and 1986, respectively, and every 2 years thereafter.

During follow-up of 22 years among 77,527 women and 26 years among 45,913 men, the investigators documented 438 cases of RCC (230 in women and 208 in men). Of these cases, 106 were fatal (56 in women, 40 in men).

In a pooled multivariate analysis, regular use of aspirin was not significantly associated with RCC risk, but regular use of non-aspirin NSAIDs was associated with a significant 34% increased risk.

The study found that the risk of fatal RCC increased with increasing duration of non-aspirin NSAID use. Subjects who regularly used non-aspirin NSAIDs for at least 4 years but less than 10 years and 10 or more years had a nearly 2 times and 4 times increased relative risk of fatal RCC, respectively, compared with those who did not regularly use the drugs, Dr. Preston's team reported. Women who regularly used non-aspirin NSAIDs for at least 4 years but less than 10 years and 10 or more years had a significant 1.9 times and 4.8-fold times increased relative risk of fatal RCC, respectively. The researchers found no significant association between regular use of non-aspirin NSAIDs and fatal RCC in men. Regular aspirin use had no significant effect on the risk of fatal RCC in either women or men.

In a previous study published in Archives of Internal Medicine (2011;171:1487-1493), researchers analyzing data from the NHS and HPFS found that aspirin and acetaminophen were not associated with RCC risk, but regular use of non-aspirin NSAIDs was associated with a 51% increased risk in pooled multivariate analysis. Longer duration of non-aspirin NSAID use was associated with increasing RCC risk. 

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