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Aspirin/NSAID and oesophageal cancer

 

Clinical bottom line

There appears to be a protective association between aspirin/NSAIDs and oesophageal cancer, of both histological types, and with a dose effect.


Reference

DA Corley et al. Protective association of aspirin/NSAIDs and esophageal cancer: a systematic review and meta-analysis. Gastroenterology 2003 124: 47-56.

Review

Five electronic databases, including the Cochrane Library, were searched for studies relating aspirin or NSAIDs and oesophageal cancer. Review articles and society abstracts were also searched. For inclusion, studies had to evaluate exposure to aspirin/NSAIDs, measure occurrence of oesophageal cancer and report relative risk or odds ratios, or have data for their calculation.

Results

There were nine studies with 1,813 cases. Two were cohort studies and the remainder case control studies.

Patients with any exposure to aspirin/NSAIDs had a 43% reduction in the odds of developing oesophageal cancer (odds ratio 0.6; 0.5 to 0.7). There was evidence for a dose effect, with a higher reduction with frequent aspirin/NSAIDs use (0.5; 0.4 to 0.7) compared with less frequent use. The effects were the same for adenocarcinoma or squamous cell carcinoma.

Aspirin use had a somewhat lower odds ratio (0.5; 0.4 to 0.7) than did NSAID use (0.7; 0.5 to 1.0). The cohort and case control studies gave similar results.

Comment

There appears to be a protective association between aspirin/NSAIDs and oesophageal cancer, of both histological types, and with a dose effect.