Aspirin and NSAID use and lung cancer risk: A pooled analysis in the International Lung Cancer Consortium (ILCCO)

Valerie A. McCormack, Rayjean J. Hung, Darren R. Brenner, Heike Bickeböller, Albert Rosenberger, Joshua E. Muscat, Philip Lazarus, Anne Tjønneland, Søren Friis, David C. Christiani, Eun Mi Chun, Loic Le Marchand, Gad Rennert, Hedy S. Rennert, Angeline S. Andrew, Irene Orlow, Bernard Park, Paolo Boffetta, Eric J. Duell

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42 Scopus citations


Purpose: To investigate the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) lower lung cancer risk. Methods: We analysed pooled individual-level data from seven case-control and one cohort study in the International Lung Cancer Consortium (ILCCO). Relative risks for lung cancer associated with self-reported history of aspirin and other NSAID use were estimated within individual studies using logistic regression or proportional hazards models, adjusted for packyears of smoking, age, calendar period, ethnicity and education and were combined using random effects meta-analysis. Results: A total of 4,309 lung cancer cases (mean age at diagnosis 65 years, 45% adenocarcinoma and 22% squamous-cell carcinoma) and 58,301 non-cases/controls were included. Amongst controls, 34% had used NSAIDs in the past (81% of them used aspirin). After adjustment for negative confounding by smoking, ever-NSAID use (affirmative answer to the study-specific question on NSAID use) was associated with a 26% reduction (95% confidence interval 8 to 41%) in lung cancer risk in men, but not in women (3% increase (-11% to 30%)). In men, the association was stronger in current and former smokers, and for squamous-cell carcinoma than for adenocarcinomas, but there was no trend with duration of use. No differences were found in the effects on lung cancer risk of aspirin and non-aspirin NSAIDs. Conclusions: Evidence from ILCCO suggests that NSAID use in men confers a modest protection for lung cancer, especially amongst ever-smokers. Additional investigation is needed regarding the possible effects of age, duration, dose and type of NSAID and whether effect modification by smoking status or sex exists.

Original languageEnglish
Pages (from-to)1709-1720
Number of pages12
JournalCancer Causes and Control
Issue number12
StatePublished - Dec 2011

Bibliographical note

Funding Information:
Acknowledgments The ILCCO data management is supported by Canadian Cancer Society (CCSRI no. 020214) and Cancer Care Ontario Research Chair Award. Individual ILCCO studies were funded or supported by various institutions and organisations. NEL-CS: Grant Number P20RR018787 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH); MSKCC: Steps for Breath and the Labrecque Foundation, the Society of Memorial Sloan-Kettering Cancer Center. The authors would like to thank the following for their contribution with data management: Urvi Mujumdar and Radhai Rastogi (MSKCC) and Katja Boll (DDCHS).


  • Aspirin
  • Lung cancer
  • NSAIDs


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