New data suggest that acetaminophen may prevent prostate cancer

Over the years, a variety of studies have demonstrated a possible impact of aspirin and other non-steroidal anti-inflammatory agents or NSAIDs (e.g., ibuprofen, COX-2 inhibitors) on risk for prostate cancer. (See, for example, this report from late in 2010.)

Strictly speaking, acetaminophen (the active ingredient in Tylenol and other over-the-counter products) is not an NSAID at all, but of course it is well known to have anti-inflammatory effects.

A new paper by Jacobs et al., just published in Cancer Epidemiology, Biomarkers & Prevention, has now suggested that regular, long-term use of acetaminophen (30 or more tablets a month for a period of at least 5 years) is associated with a significant reduction in risk of a diagnosis of prostate cancer in general and aggressive forms of prostate cancer in particular.

The research team from the American Cancer Society used data from the 78,485 men enrolled in the Cancer Prevention Study II Nutrition Cohort. Men in this study initially provided data on their use of acetaminophen use in a questionnaire completed at study enrollment in 1992. Follow-up questionnaires were completed in 1997 and every 2 years thereafter.

The mathematical models used to make estimates of the impact of acetaminophen use had to take account of and be adjusted for such things as age, race, education, body mass index, diabetes, NSAID use, and history of prostate-specific antigen (PSA) testing.

The key results of the study reported by the authors are as follows:

  • 8,092 incident prostate cancer cases were identified in the study cohort between 1992 and 2007.
  • Regular use of acetaminophen (≥30 pills per month) for ≥5 years before and during the study was associated with
    • A 38 percent reduction in relative risk of all prostate cancer (RR = 0.62)
    • A 51 percent reduction in relative risk of aggressive prostate cancer (RR = 0.49).
  • Regular use of acetaminophen for < 5 years before or during the study was not associated with prostate cancer risk.

Jacobs et al. conclude that their results “suggest that long-term regular acetaminophen use may be associated with lower prostate cancer risk.”

This paper is also discussed in an article on the Los Angeles Times Booster Shots blog site. Clearly, if an association between the regular, long-term use of acetaminophen and a reduction in risk of prostate cancer can be confirmed, we may gain important insights into biological mechanisms that underlie the development of prostate cancer. However, it is important to understand that retrospective reviews of this type must be assessed with care. This study can not be taken to provide definitive proof that regular use of acetaminophen can reduce a man’s risk for prostate cancer, and the long-term use of acetaminophen (like the long-term use of aspirin and other NSAIDs) is associated with the potential development of a variety of significant side effects.

3 Responses

  1. You’re right to warn about the (long-term) side-effects of acetaminophen, especially given the recent recall of children’s Tylenol. Just as aspirin can mess up your digestion and lead to hemorrhaging, ingesting acetaminophen can really compromise your liver when taken regularly. I also agree with your assessment that you cannot draw a plan of action to reduce prostate cancer exclusively on the basis of retrospective versus prospective studies. It would be good if the public became more aware of the distinction.

  2. Aloha,

    I’ve had serious sinus problems since the late 70s and as part of the treatment I was using aspirin, sometimes heavy use (12/day), to control sinus infection. I still use aspirin when my sinus drainage turns yellow. I have not experienced any serious side affects. This aspirin use did not prevent high risk prostate cancer 4 years ago (12 of 12 cores).


  3. We really have no idea whatsoever why drugs like aspirin and acetaminophen appear to have a protective effect against risk for prostate cancer in some men but absolutely no effect in others. We assume that it has some relationship to the anti-inflammatory and other effects of these drugs — but that’s all we have to work on, an assumption.

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