VITAL says NSAIDs not effective in prostate cancer prevention

Data from the VITAL cohort study do not support the use of non-steroidal anti-inflammatory drugs (NSAIDs) in the chemoprevention of prostate cancer, according to a newly published study.

The answer to the question of whether long-term use of any of the NSAIDs (including aspirin) really has any impact on the prevention of prostate cancer continues to wave backward and forward in the wind. These new data from the VITamins And Lifestyle (VITAL) cohort study provide us with more information, but they don’t provide any final resolution of the answer to the core question.

The VITAL cohort study included 34,132 men, aged between 50 and 76 years, and all living in western Washington State. According to the new article by Braksy et al.:

  • 1,550 members of this cohort were diagnosed with prostate cancer, which could be categorized by Gleason grade.
  • Use of low-dose aspirin, regular-strength aspirin, ibuprofen, and non-aspirin NSAIDs (ibuprofen, naproxen, and COX-2 inhibitors) were not associated with overall prostate cancer risk.
  • Use of regular-strength aspirin was associated with a small reduction in risk of high-grade prostate cancer (hazard ratio [HR] = 0.73).

Aspirin and NSAIDs are well known to carry risks for internal bleeding and related complications. Even a daily “mini-aspirin” (a dose of just 75 mg/day) is not without risk. Patients should not start to self-medicate with any NSAID without first discussing this with their doctor.

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