NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND PROSTATE-CANCER PROGRESSION

Experimental studies have suggested that the biosynthesis of arachidon ic acid-derived eicosanoids such as prostaglandin E-2 via the cyclo ox ygenase pathway may play a significant role in supporting cell prolife ration in human prostate cancer cell lines. However, the aetiological significance of this for clinical prostate cancer has remained unclear . In particular, the potential for prostate cancer chemoprevention usi ng nonsteroidal anti-inflammatory drugs (cyclo-oxygenase, inhibitors; NSAIDs) has received little attentions.The purpose of our study was to investigate associations between prostate cancer risk and use of NSAI Ds. A population-based case- control study Was carried out over 13 mon ths from 1996 in metropolitan Auckland, New Zealand. A total of 317 ne wly diagnosed prostate cancer cases (including 192 ''advanced'' cases) representative of all cancer cases in the study population were ident ified from urology clinic referrals and histology reports. A total of 480 age-matched controls were recruited following random selection fro m the study population using electoral rolls as the sampling frame. Af ter adjusting for potential confounding by socio economic status and d ietary fat consumption, there was a trend toward reduced risks of adva nced prostate cancer associated with regular use of total NSAIDs (RR = 0.73; 95% CI 0.50-1.07) and total aspirin (RR = 0.71; 95% CI 0.47-1.0 8). However, these associations failed to reach statistical significan ce at the usually accepted levels. Weaker inverse associations were fo und for total prostate cancers, which included a number of small, low- grade tumours of less clinical significance. These findings lend suppo rt to proposed underlying aetiological hypotheses which imply a role f or cyclo-oxygenase activity in prostate cancer progression. Int. J. Ca ncer 77:511-515, 1998. (C) 1998 Wiley-Liss, inc.