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JNCI Journal of the National Cancer Institute 2004 96(4):305-315; doi:10.1093/jnci/djh038
© 2004 by Oxford University Press
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© 2004 Oxford University Press

ARTICLE

Aspirin and the Risk of Hodgkin's Lymphoma in a Population-Based Case–Control Study

Ellen T. Chang, Tongzhang Zheng, Edward G. Weir, Michael Borowitz, Risa B. Mann, Donna Spiegelman, Nancy E. Mueller

Affiliations of authors: Harvard School of Public Health, Boston, MA (ETC, DS, NEM); Yale University School of Medicine, New Haven, CT (TZ); The Johns Hopkins Medical Institute, Baltimore, MD (EGW, MB, RBM).

Correspondence to: Ellen T. Chang, ScD, Harvard School of Public Health, Department of Epidemiology, 677 Huntington Ave., Boston, MA 02115 (e-mail: echang{at}hsph.harvard.edu)

Background: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with decreased risk of several malignancies. NSAIDs may prevent cancer development by blocking the cyclooxygenase-catalyzed synthesis of proinflammatory prostaglandins. Aspirin may also protect against Hodgkin's lymphoma by inhibiting transcription factor nuclear factor {kappa}B (NF-{kappa}B), which is necessary for immune function and the survival of Hodgkin's lymphoma cells. We examined the association between regular analgesic use and the risk of Hodgkin's lymphoma. Methods: A population-based case–control study of 565 case patients with Hodgkin's lymphoma and 679 control subjects was conducted in the metropolitan area of Boston, Massachusetts, and in the state of Connecticut. Participants reported their average use of aspirin, non-aspirin NSAIDs, and acetaminophen over the previous 5 years. Regular analgesic use was defined as consumption of at least two tablets per week on average over the preceding 5 years; non-regular use was defined as consumption of fewer than two tablets per week. Results: The risk of Hodgkin's lymphoma associated with regular aspirin use was statistically significantly lower (odds ratio [OR] = 0.60, 95% confidence interval [CI] = 0.42 to 0.85) than that associated with non-regular aspirin use. The risk was not associated with use of other non-aspirin NSAIDs (OR = 0.97, 95% CI = 0.73 to 1.30). However, the risk associated with regular acetaminophen use was statistically significantly higher (OR = 1.72, 95% CI = 1.29 to 2.31) than that associated with non-regular use. Conclusion: The inverse association between aspirin, but not other NSAIDs, and Hodgkin's lymphoma suggests that NF-{kappa}B signaling may play a key role in Hodgkin's lymphoma pathogenesis.



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