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Aspirin Use May Be Associated With Reduced Risk of Hodgkin's Lymphoma

Regular use of aspirin, but not other nonsteroidal anti-inflammatory drugs (NSAIDs), is associated with a significant reduction in risk of Hodgkin's lymphoma compared with non-regular use, researchers have found.

Aspirin inhibits transcription factor nuclear factor kappa B, which regulates genes involved in immune and inflammatory responses. Ellen T. Chang, ScD, Harvard School of Public Health, Boston, Massachusetts, United States, and colleagues investigated whether the risk of Hodgkin's lymphoma, a cancer characterised by chronic immune dysfunction and inflammation, may be associated with analgesic use.

The researchers evaluated 565 patients with Hodgkin's lymphoma, ages 15 to 79 years, and 679 control subjects who were frequency matched to the patient distribution by age, sex, and state of residence.

Data collection occurred by structured telephone interview or abbreviated questionnaire, in which participants reported their average use of aspirin, ibuprofen or non-aspirin NSAIDs, and acetaminophen over the previous 5 years. Other patient information was obtained from medical records.

For analysis, analgesic exposure was calculated in terms of the number of days per month, the number of tablets taken per day, and the medication strength. Use of each medication was coded as a binary variable, with regular users defined as an average consumption of 2 or more tablets per week and non-users defined as those taking fewer than 2 tablets per week.

Results showed that the risk of Hodgkin's lymphoma associated with regular aspirin use was significantly lower (odds ratio [OR] = .60, 95% confidence interval [CI] = .42 to .85) than that associated with non-regular aspirin use. The association was consistent regardless of age, sex, race, religion, smoking history, analgesic use, and tumour Epstein-Barr virus (EBV) status.

Alternatively, regular acetaminophen use was associated with a significantly higher risk of Hodgkin's lymphoma (OR = 1.72, 95% CI = 1.29 to 2.31) compared with non-regular use. A dose-response analysis revealed that for both aspirin and acetaminophen, regular use was more strongly associated with the risk of Hodgkin's lymphoma was stronger than occasional use.

The use of other NSAIDs was not significantly associated with Hodgkin's lymphoma risk (OR = .97, 95% CI = .73 to 1.30).

Although the findings require confirmation in other populations, the researchers suggest an attractive hypothesis is that anti-inflammatory drugs guard against the onset of disease.

"If aspirin use is indeed found to protect against Hodgkin's lymphoma, this relationship could afford insight into the pathogenesis of the disease and offer possible clues toward its prevention," they said.

J Natl Cancer Inst 2004 Feb 18;96:4:305-15. "Aspirin and the risk of Hodgkin's lymphoma in a population-based case-control study"

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