Skip to main content

Advertisement

SpringerLink
Log in

Aspirin use and breast cancer risk: a meta-analysis

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Animal and in vitro studies suggest that the use of aspirin may be associated with reduced risk for breast cancer, but results from these studies of the association have been inconsistent. The objective of this meta-analysis was to quantitatively summarize the current evidence for such a relationship. We searched MEDLINE for studies of aspirin use and breast cancer risk that were published in any language, from January 1, 1966, to July 1, 2011. A total of 33 studies (19 cohort studies, 13 case–control studies, and 1 randomized controlled trial [RCT]) that included 1,916,448 subjects were identified. We pooled the relative risks from individual studies using a random-effects model, heterogeneity, and publication bias analyses. In a pooled analysis of all studies, aspirin use was associated with reduced risk for breast cancer (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.81, 0.92). In the subgroup analysis by study design, results were similar except for RCT (OR = 0.98, 95% CI = 0.87, 1.09). In conclusion, this meta-analysis indicated that regular use of aspirin may be associated with reduced risk of breast cancer. More RCT were needed to confirm this association in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57(1):43–66

    Article  PubMed  Google Scholar 

  2. Muss HB, Berry DA, Cirrincione CT, Theodoulou M, Mauer AM, Kornblith AB, Partridge AH, Dressler LG, Cohen HJ, Becker HP, Kartcheske PA, Wheeler JD, Perez EA, Wolff AC, Gralow JR, Burstein HJ, Mahmood AA, Magrinat G, Parker BA, Hart RD, Grenier D, Norton L, Hudis CA, Winer EP (2009) Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med 360(20):2055–2065

    Article  PubMed  CAS  Google Scholar 

  3. Chlebowski RT, Blackburn GL, Thomson CA, Nixon DW, Shapiro A, Hoy MK, Goodman MT, Giuliano AE, Karanja N, McAndrew P, Hudis C, Butler J, Merkel D, Kristal A, Caan B, Michaelson R, Vinciguerra V, Del Prete S, Winkler M, Hall R, Simon M, Winters BL, Elashoff RM (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results from the women’s intervention nutrition study. J Natl Cancer Inst 98(24):1767–1776

    Article  PubMed  Google Scholar 

  4. Holmes MD, Chen WY, Li L, Hertzmark E, Spiegelman D, Hankinson SE (2010) Aspirin intake and survival after breast cancer. J Clin Oncol 28(9):1467–1472

    Article  PubMed  CAS  Google Scholar 

  5. Zhao YS, Zhu S, Li XW, Wang F, Hu FL, Li DD, Zhang WC, Li X (2009) Association between NSAIDs use and breast cancer risk: a systematic review and meta-analysis. Breast Cancer Res Treat 117(1):141–150

    Article  PubMed  CAS  Google Scholar 

  6. Takkouche B, Regueira-Mendez C, Etminan M (2008) Breast cancer and use of nonsteroidal anti-inflammatory drugs: a meta-analysis. J Natl Cancer Inst 100(20):1439–1447

    Article  PubMed  CAS  Google Scholar 

  7. Khuder SA, Mutgi AB (2001) Breast cancer and NSAID use: a meta-analysis. Br J Cancer 84(9):1188–1192

    Article  PubMed  CAS  Google Scholar 

  8. Mangiapane S, Blettner M, Schlattmann P (2008) Aspirin use, breast cancer risk: a meta-analysis, meta-regression of observational studies from 2001 to 2005. Pharmacoepidemiol Drug Saf 17(2):115–124

    Article  PubMed  Google Scholar 

  9. Greenland S (1987) Quantitative methods in the review of epidemiologic literature. Epidemiol Rev 9:1–30

    PubMed  CAS  Google Scholar 

  10. Robins J, Greenland S, Breslow NE (1986) A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J Epidemiol 124(5):719–723

    PubMed  CAS  Google Scholar 

  11. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  PubMed  CAS  Google Scholar 

  12. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    Article  PubMed  CAS  Google Scholar 

  13. Bardia A, Olson JE, Vachon CM, Lazovich D, Vierkant RA, Wang AH, Limburg PJ, Anderson KE, Cerhan JR (2011) Effect of aspirin and other NSAIDs on postmenopausal breast cancer incidence by hormone receptor status: results from a prospective cohort study. Breast Cancer Res Treat 126(1):149–155

    Article  PubMed  CAS  Google Scholar 

  14. Cronin-Fenton DP, Pedersen L, Lash TL, Friis S, Baron JA, Sorensen HT (2010) Prescriptions for selective cyclooxygenase-2 inhibitors, non-selective non-steroidal anti-inflammatory drugs, and risk of breast cancer in a population-based case–control study. Breast Cancer Res 12(2):R15

    Article  PubMed  Google Scholar 

  15. Brasky TM, Bonner MR, Moysich KB, Ambrosone CB, Nie J, Tao MH, Edge SB, Kallakury BV, Marian C, Trevisan M, Shields PG, Freudenheim JL (2010) Non-steroidal anti-inflammatory drug (NSAID) use and breast cancer risk in the western New York exposures and breast cancer (WEB) study. Cancer Causes Control 21(9):1503–1512

    Article  PubMed  Google Scholar 

  16. Eliassen AH, Chen WY, Spiegelman D, Willett WC, Hunter DJ, Hankinson SE (2009) Use of aspirin, other nonsteroidal anti-inflammatory drugs, and acetaminophen and risk of breast cancer among premenopausal women in the nurses’ health study II. Arch Intern Med 169(2):115–121 Discussion: 121

    Article  PubMed  Google Scholar 

  17. Friis S, Thomassen L, Sorensen HT, Tjonneland A, Overvad K, Cronin-Fenton DP, Vogel U, McLaughlin JK, Blot WJ, Olsen JH (2008) Nonsteroidal anti-inflammatory drug use and breast cancer risk: a Danish cohort study. Eur J Cancer Prev 17(2):88–96

    Article  PubMed  Google Scholar 

  18. Ready A, Velicer CM, McTiernan A, White E (2008) NSAID use and breast cancer risk in the VITAL cohort. Breast Cancer Res Treat 109(3):533–543

    Article  PubMed  CAS  Google Scholar 

  19. Gierach GL, Lacey JV Jr, Schatzkin A, Leitzmann MF, Richesson D, Hollenbeck AR, Brinton LA (2008) Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health-AARP Diet and Health Study. Breast Cancer Res 10(2):R38

    Article  PubMed  Google Scholar 

  20. Gill JK, Maskarinec G, Wilkens LR, Pike MC, Henderson BE, Kolonel LN (2007) Nonsteroidal antiinflammatory drugs and breast cancer risk: the multiethnic cohort. Am J Epidemiol 166(10):1150–1158

    Article  PubMed  Google Scholar 

  21. Jacobs EJ, Thun MJ, Bain EB, Rodriguez C, Henley SJ, Calle EE (2007) A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence. J Natl Cancer Inst 99(8):608–615

    Article  PubMed  CAS  Google Scholar 

  22. Slattery ML, Curtin K, Baumgartner R, Sweeney C, Byers T, Giuliano AR, Baumgartner KB, Wolff RR (2007) IL6, aspirin, nonsteroidal anti-inflammatory drugs, and breast cancer risk in women living in the southwestern United States. Cancer Epidemiol Biomarkers Prev 16(4):747–755

    Article  PubMed  CAS  Google Scholar 

  23. Gallicchio L, Visvanathan K, Burke A, Hoffman SC, Helzlsouer KJ (2007) Nonsteroidal anti-inflammatory drugs and the risk of developing breast cancer in a population-based prospective cohort study in Washington County, MD. Int J Cancer 121(1):211–215

    Article  PubMed  CAS  Google Scholar 

  24. Harris RE, Beebe-Donk J, Alshafie GA (2006) Reduction in the risk of human breast cancer by selective cyclooxygenase-2 (COX-2) inhibitors. BMC Cancer 6:27

    Article  PubMed  Google Scholar 

  25. Marshall SF, Bernstein L, Anton-Culver H, Deapen D, Horn-Ross PL, Mohrenweiser H, Peel D, Pinder R, Purdie DM, Reynolds P, Stram D, West D, Wright WE, Ziogas A, Ross RK (2005) Nonsteroidal anti-inflammatory drug use and breast cancer risk by stage and hormone receptor status. J Natl Cancer Inst 97(11):805–812

    Article  PubMed  CAS  Google Scholar 

  26. Zhang Y, Coogan PF, Palmer JR, Strom BL, Rosenberg L (2005) Use of nonsteroidal antiinflammatory drugs and risk of breast cancer: the case–control surveillance study revisited. Am J Epidemiol 162(2):165–170

    Article  PubMed  Google Scholar 

  27. Swede H, Mirand AL, Menezes RJ, Moysich KB (2005) Association of regular aspirin use and breast cancer risk. Oncology 68(1):40–47

    Article  PubMed  CAS  Google Scholar 

  28. Rahme E, Ghosn J, Dasgupta K, Rajan R, Hudson M (2005) Association between frequent use of nonsteroidal anti-inflammatory drugs and breast cancer. BMC Cancer 5:159

    Article  PubMed  Google Scholar 

  29. Cook NR, Lee IM, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE (2005) Low-dose aspirin in the primary prevention of cancer: the women’s health study: a randomized controlled trial. JAMA 294(1):47–55

    Article  PubMed  CAS  Google Scholar 

  30. Garcia Rodriguez LA, Gonzalez-Perez A (2004) Risk of breast cancer among users of aspirin and other anti-inflammatory drugs. Br J Cancer 91(3):525–529

    Article  PubMed  CAS  Google Scholar 

  31. Terry MB, Gammon MD, Zhang FF, Tawfik H, Teitelbaum SL, Britton JA, Subbaramaiah K, Dannenberg AJ, Neugut AI (2004) Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk. JAMA 291(20):2433–2440

    Article  PubMed  CAS  Google Scholar 

  32. Ratnasinghe LD, Graubard BI, Kahle L, Tangrea JA, Taylor PR, Hawk E (2004) Aspirin use and mortality from cancer in a prospective cohort study. Anticancer Res 24(5B):3177–3184

    PubMed  Google Scholar 

  33. Moorman PG, Grubber JM, Millikan RC, Newman B (2003) Association between non-steroidal anti-inflammatory drugs (NSAIDs) and invasive breast cancer and carcinoma in situ of the breast. Cancer Causes Control 14(10):915–922

    Article  PubMed  Google Scholar 

  34. Harris RE, Chlebowski RT, Jackson RD, Frid DJ, Ascenseo JL, Anderson G, Loar A, Rodabough RJ, White E, McTiernan A (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the women’s health initiative. Cancer Res 63(18):6096–6101

    PubMed  CAS  Google Scholar 

  35. Johnson TW, Anderson KE, Lazovich D, Folsom AR (2002) Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. Cancer Epidemiol Biomarkers Prev 11(12):1586–1591

    PubMed  CAS  Google Scholar 

  36. Cotterchio M, Kreiger N, Sloan M, Steingart A (2001) Nonsteroidal anti-inflammatory drug use and breast cancer risk. Cancer Epidemiol Biomarkers Prev 10(11):1213–1217

    PubMed  CAS  Google Scholar 

  37. Harris RE, Kasbari S, Farrar WB (1999) Prospective study of nonsteroidal anti-inflammatory drugs and breast cancer. Oncol Rep 6(1):71–73

    PubMed  CAS  Google Scholar 

  38. Coogan PF, Rao SR, Rosenberg L, Palmer JR, Strom BL, Zauber AG, Stolley PD, Shapiro S (1999) The relationship of nonsteroidal anti-inflammatory drug use to the risk of breast cancer. Prev Med 29(2):72–76

    Article  PubMed  CAS  Google Scholar 

  39. Neugut AI, Rosenberg DJ, Ahsan H, Jacobson JS, Wahid N, Hagan M, Rahman MI, Khan ZR, Chen L, Pablos-Mendez A, Shea S (1998) Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomarkers Prev 7(10):869–873

    PubMed  CAS  Google Scholar 

  40. Egan KM, Stampfer MJ, Giovannucci E, Rosner BA, Colditz GA (1996) Prospective study of regular aspirin use and the risk of breast cancer. J Natl Cancer Inst 88(14):988–993

    Article  PubMed  CAS  Google Scholar 

  41. Harris RE, Namboodiri KK, Farrar WB (1996) Nonsteroidal antiinflammatory drugs and breast cancer. Epidemiology 7(2):203–205

    Article  PubMed  CAS  Google Scholar 

  42. Schreinemachers DM, Everson RB (1994) Aspirin use and lung, colon, and breast cancer incidence in a prospective study. Epidemiology 5(2):138–146

    Article  PubMed  CAS  Google Scholar 

  43. Thun MJ, Namboodiri MM, Calle EE, Flanders WD, Heath CW Jr (1993) Aspirin use and risk of fatal cancer. Cancer Res 53(6):1322–1327

    PubMed  CAS  Google Scholar 

  44. Paganini-Hill A, Chao A, Ross RK, Henderson BE (1989) Aspirin use and chronic diseases: a cohort study of the elderly. BMJ 299(6710):1247–1250

    Article  PubMed  CAS  Google Scholar 

  45. Friedman GD, Ury HK (1980) Initial screening for carcinogenicity of commonly used drugs. J Natl Cancer Inst 65(4):723–733

    PubMed  CAS  Google Scholar 

  46. Corley DA, Kerlikowske K, Verma R, Buffler P (2003) Protective association of aspirin/NSAIDs and esophageal cancer: a systematic review and meta-analysis. Gastroenterology 124(1):47–56

    Article  PubMed  CAS  Google Scholar 

  47. Din FV, Theodoratou E, Farrington SM, Tenesa A, Barnetson RA, Cetnarskyj R, Stark L, Porteous ME, Campbell H, Dunlop MG (2010) Effect of aspirin and NSAIDs on risk and survival from colorectal cancer. Gut 59(12):1670–1679

    Article  PubMed  CAS  Google Scholar 

  48. Rothwell PM, Wilson M, Elwin CE, Norrving B, Algra A, Warlow CP, Meade TW (2010) Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet 376(9754):1741–1750

    Article  PubMed  CAS  Google Scholar 

  49. Chan AT, Ogino S, Fuchs CS (2007) Aspirin and the risk of colorectal cancer in relation to the expression of COX-2. N Engl J Med 356(21):2131–2142

    Article  PubMed  CAS  Google Scholar 

  50. Yang P, Zhou Y, Chen B, Wan HW, Jia GQ, Bai HL, Wu XT (2010) Aspirin use and the risk of gastric cancer: a meta-analysis. Dig Dis Sci 55(6):1533–1539

    Article  PubMed  CAS  Google Scholar 

  51. Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW (2011) Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet 377(9759):31–41

    Article  PubMed  CAS  Google Scholar 

  52. Dhillon PK, Kenfield SA, Stampfer MJ, Giovannucci EL (2011) Long-term aspirin use and the risk of total, high-grade, regionally advanced and lethal prostate cancer in a prospective cohort of health professionals, 1988–2006. Int J Cancer 128(10):2444–2452

    Article  PubMed  CAS  Google Scholar 

  53. Salinas CA, Kwon EM, FitzGerald LM, Feng Z, Nelson PS, Ostrander EA, Peters U, Stanford JL (2010) Use of aspirin and other nonsteroidal antiinflammatory medications in relation to prostate cancer risk. Am J Epidemiol 172(5):578–590

    Article  PubMed  Google Scholar 

  54. Jacobs EJ, Rodriguez C, Mondul AM, Connell CJ, Henley SJ, Calle EE, Thun MJ (2005) A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence. J Natl Cancer Inst 97(13):975–980

    Article  PubMed  Google Scholar 

  55. Powles TJ, Clark SA, Easty DM, Easty GC, Neville AM (1973) The inhibition by aspirin and indomethacin of osteolytic tumor deposits and hypercalcaemia in rats with Walker tumour, and its possible application to human breast cancer. Br J Cancer 28(4):316–321

    Article  PubMed  CAS  Google Scholar 

  56. Sotiriou C, Lacroix M, Lagneaux L, Berchem G, Body JJ (1999) The aspirin metabolite salicylate inhibits breast cancer cells growth and their synthesis of the osteolytic cytokines interleukins-6 and -11. Anticancer Res 19(4B):2997–3006

    PubMed  CAS  Google Scholar 

  57. Abbadessa G, Spaccamiglio A, Sartori ML, Nebbia C, Dacasto M, Di Carlo F, Racca S (2006) The aspirin metabolite, salicylate, inhibits 7, 12-dimethylbenz[a]anthracene-DNA adduct formation in breast cancer cells. Int J Oncol 28(5):1131–1140

    PubMed  CAS  Google Scholar 

  58. Alfonso LF, Srivenugopal KS, Arumugam TV, Abbruscato TJ, Weidanz JA, Bhat GJ (2009) Aspirin inhibits camptothecin-induced p21CIP1 levels and potentiates apoptosis in human breast cancer cells. Int J Oncol 34(3):597–608

    PubMed  CAS  Google Scholar 

  59. Bhattacharyya M, Girish GV, Ghosh R, Chakraborty S, Sinha AK (2010) Acetyl salicylic acid (aspirin) improves synthesis of maspin and lowers incidence of metastasis in breast cancer patients [corrected]. Cancer Sci 101(10):2105–2109

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Head & Neck and Mammary Oncology, Cancer Center and State Key Laboratory of Biotherapy, Laboratory of Molecular Diagnosis of Cancer, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China

    Ting Luo, Hua-Mei Yan, Ping He, Yong Luo, Yuan-Fu Yang & Hong Zheng

Authors
  1. Ting Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hua-Mei Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ping He
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yong Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuan-Fu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hong Zheng.

Additional information

The author Hua-Mei Yan contributed equally to the work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Luo, T., Yan, HM., He, P. et al. Aspirin use and breast cancer risk: a meta-analysis. Breast Cancer Res Treat 131, 581–587 (2012). https://doi.org/10.1007/s10549-011-1747-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-011-1747-0

Keywords

Search

Navigation