The Association between NSAID use and Colorectal Cancer Mortality: Results from the Women's Health Initiative.

Publication Type:

Journal Article


Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, Volume 21, Issue 11, p.1966-73 (2012)


2012, Center-Authored Paper, Public Health Sciences Division, September 2012


BACKGROUND: Randomized trial evidence demonstrates that non-steroidal anti-inflammatory drug (NSAID) use, particularly long-term use, reduces the incidence of colorectal neoplasia. Recent data also suggests an inverse association between NSAID use and death due to colorectal cancer (CRC). METHODS: We examined the association between NSAID use and CRC mortality among 160,143 post-menopausal women enrolled in the Women's Health Initiative. Women provided details on medication use at baseline and three years after enrollment. Reported CRC cases were locally confirmed and centrally adjudicated; cause of death was determined according to centralized medical record and death certificate review. Cox regression was used to investigate the association between NSAID use and CRC mortality. RESULTS: Overall, NSAID use at baseline was not associated with CRC mortality (HR: 0.93; 95% CI 0.76, 1.14). However, women who reported NSAID use at both baseline and year-three experienced reductions in CRC mortality (HR: 0.72; 95% CI 0.54, 0.95) compared to non-users. CONCLUSIONS: Results suggest that NSAID use is associated with lower CRC mortality among post-menopausal women who use these medications more consistently over time. Impact:Our results support prolonged NSAID use in post-menopausal women for the prevention of poor CRC outcomes.