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Dierssen-Sotos T, Gómez-Acebo I, de Pedro M, Pérez-Gómez B, Servitja S, Moreno V, Amiano P, Fernandez-Villa T, Barricarte A, Tardon A, Diaz-Santos M, Peiro-Perez R, Marcos-Gragera R, Lope V, Gracia-Lavedan E, Alonso MH, Michelena-Echeveste MJ, Garcia-Palomo A, Guevara M, Castaño-Vinyals G, Aragonés N, Kogevinas M, Pollán M, Llorca J. Use of non-steroidal anti-inflammatory drugs and risk of breast cancer: The Spanish Multi-Case-control (MCC) study. BMC Cancer 2016; 16:660. [PMID: 27542890 PMCID: PMC4992258 DOI: 10.1186/s12885-016-2692-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 08/09/2016] [Indexed: 12/20/2022] Open
Abstract
Background The relationship between non-steroidal anti-inflammatory drug (NSAID) consumption and breast cancer has been repeatedly studied, although the results remain controversial. Most case-control studies reported that NSAID consumption protected against breast cancer, while most cohort studies did not find this effect. Most studies have dealt with NSAIDs as a whole group or with specific drugs, such aspirin, ibuprofen, or others, but not with NSAID subgroups according to the Anatomical Therapeutic Chemical Classification System; moreover, scarce attention has been paid to their effect on different tumor categories (i.e.: ductal/non-ductal, stage at diagnosis or presence of hormonal receptors). Methods In this case-control study, we report the NSAID – breast cancer relationship in 1736 breast cancer cases and 1895 healthy controls; results are reported stratifying by the women’s characteristics (i.e.: menopausal status or body mass index category) and by tumor characteristics. Results In our study, NSAID use was associated with a 24 % reduction in breast cancer risk (Odds ratio [OR] = 0.76; 95 % Confidence Interval [CI]: 0.64–0.89), and similar results were found for acetic acid derivatives, propionic acid derivatives and COXIBs, but not for aspirin. Similar results were found in postmenopausal and premenopausal women. NSAID consumption also protected against hormone + or HER2+ cancers, but not against triple negative breast cancers. The COX-2 selectivity showed an inverse association with breast cancer (i.e. OR < 1), except in advanced clinical stage and triple negative cancers. Conclusion Most NSAIDs, but not aspirin, showed an inverse association against breast cancer; this effect seems to be restricted to hormone + or HER2+ cancers. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2692-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Trinidad Dierssen-Sotos
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. .,University of Cantabria - IDIVAL, Santander, Spain.
| | - Inés Gómez-Acebo
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,University of Cantabria - IDIVAL, Santander, Spain
| | - María de Pedro
- Department of Obstetrics and Gynecology, Nuevo Belén University Hospital, Madrid, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Sonia Servitja
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain.,Cancer Research Program IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Víctor Moreno
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, and University of Barcelona, Barcelona, Spain
| | - Pilar Amiano
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Tania Fernandez-Villa
- Área de Medicina Preventiva y Salud Pública, Departamento de Ciencias Biomédicas, Universidad de León, León, España.,Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Universidad de León, León, España
| | - Aurelio Barricarte
- Navarra Public Health Institute, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Adonina Tardon
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,IUOPA, Universidad de Oviedo, Oviedo, Spain
| | - Marian Diaz-Santos
- Universidad de Huelva, Huelva, Spain.,Centro de Investigación en Salud y Medio Ambiente (CYSMA), Huelva, Spain
| | - Rosana Peiro-Perez
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Area de Cáncer y Salud Pública, Fundación FISABIO- Salud Pública, Valencia, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia and Descriptive Epidemiology, Genetics and Cancer Prevention Group [Girona Biomedical Research Institute (IdIBGi)], Catalan Institute of Oncology, Girona, Spain
| | - Virginia Lope
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Esther Gracia-Lavedan
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M Henar Alonso
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, and University of Barcelona, Barcelona, Spain
| | | | | | - Marcela Guevara
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Navarra Public Health Institute, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Gemma Castaño-Vinyals
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Nuria Aragonés
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marina Pollán
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,University of Cantabria - IDIVAL, Santander, Spain
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Gómez-Acebo I, Dierssen-Sotos T, Palazuelos C, Pérez-Gómez B, Lope V, Tusquets I, Alonso MH, Moreno V, Amiano P, Molina de la Torre AJ, Barricarte A, Tardon A, Camacho A, Peiro-Perez R, Marcos-Gragera R, Muñoz M, Michelena-Echeveste MJ, Ortega Valin L, Guevara M, Castaño-Vinyals G, Aragonés N, Kogevinas M, Pollán M, Llorca J. The Use of Antihypertensive Medication and the Risk of Breast Cancer in a Case-Control Study in a Spanish Population: The MCC-Spain Study. PLoS One 2016; 11:e0159672. [PMID: 27508297 PMCID: PMC4979888 DOI: 10.1371/journal.pone.0159672] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/05/2016] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The evidence on the relationship between breast cancer and different types of antihypertensive drugs taken for at least 5 years is limited and inconsistent. Furthermore, the debate has recently been fueled again with new data reporting an increased risk of breast cancer among women with a long history of use of antihypertensive drugs compared with nonusers. METHODS In this case-control study, we report the antihypertensive drugs-breast cancer relationship in 1,736 breast cancer cases and 1,895 healthy controls; results are reported stratifying by the women's characteristics (i.e., menopausal status or body mass index category) tumor characteristics and length of use of antihypertensive drugs. RESULTS The relationship among breast cancer and use of calcium channel blockers (CCB) for 5 or more years had odds ratio (OR) = 1.77 (95% CI, 0.99 to 3.17). Stratifying by BMI, the OR increased significantly in the group with BMI ≥ 25 (OR 2.54, 95% CI, 1.24 to 5.22). CCBs were even more strongly associated with more aggressive tumors, (OR for invasive tumors = 1.96, 95% CI = 1.09 to 3.53; OR for non ductal cancers = 3.97, 95% CI = 1.73 to 9.05; OR for Erbb2+ cancer = 2.97, 95% CI: 1.20 to 7.32). On the other hand, premenopausal women were the only group in which angiotensin II receptor blockers may be associated with breast cancer (OR = 4.27, 95% CI = 1.32 to 13.84) but this could not be identified with any type or stage. Use of angiotensin-converting-enzyme inhibitors, beta blockers and diuretics were not associated with risk. CONCLUSIONS In this large population-based study we found that long term use of calcium channel blockers is associated with some subtypes of breast cancer (and with breast cancer in overweight women).
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Affiliation(s)
- Inés Gómez-Acebo
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria–IDIVAL, Santander, Spain
| | - Trinidad Dierssen-Sotos
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria–IDIVAL, Santander, Spain
| | | | - Beatriz Pérez-Gómez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Virginia Lope
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Ignasi Tusquets
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
- Cancer Research Program IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M. Henar Alonso
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, and University of Barcelona, Barcelona, Spain
| | - Victor Moreno
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, and University of Barcelona, Barcelona, Spain
| | - Pilar Amiano
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Guipuzkoa, Spain
| | - Antonio José Molina de la Torre
- Área de Medicina Preventiva y Salud Pública, Departamento de Ciencias Biomédicas, Universidad de León, León, España
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Universidad de León, León, España
| | - Aurelio Barricarte
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain
| | - Adonina Tardon
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- IUOPA, Universidad de Oviedo, Oviedo, Spain
| | - Antonio Camacho
- Hospital Juan Ramon Jimenez, Andalusian Health Service, Huelva, España
- Research Center for Health and the Environment (CYSMA), Universidad de Huelva, Huelva, España
| | - Rosana Peiro-Perez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Area de Cáncer y Salud Pública, Fundación FISABIO- Salud Pública, Valencia, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia and Descriptive Epidemiology, Genetics and Cancer Prevention Group [Girona Biomedical Research Institute (IdIBGi)], Catalan Institute of Oncology, Girona, Spain
| | - Montse Muñoz
- Translational Genomics and Targeted Therapeutics in Solid Tumors (IDIBAPS), Barcelona, Spain
| | | | | | - Marcela Guevara
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Universidad de León, León, España
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Gemma Castaño-Vinyals
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Nuria Aragonés
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marina Pollán
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria–IDIVAL, Santander, Spain
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