© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 11, 973B-974,
June 2, 1999
© 1999 Oxford University Press
CORRESPONDENCE |
RESPONSE: Re: Trends in Reported Incidence of Primary Malignant Brain Tumors in Children in the United States
Affiliations of authors: M. A. Smith, R. Simon (Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis), L. A. Gloeckler Ries (Cancer Surveillance Research Program, Division of Cancer Control and Population Sciences), National Cancer Institute, Bethesda, MD; B. Freidlin, Emmes Corporation, Rockville, MD.
Correspondence to: Malcolm A. Smith, M.D., PhD., National Institutes of Health, Executive Plaza North, Rm. 741, Bethesda, MD 20892-7436 (smithm{at}ctep.nih.gov).
Dr. Varner questions whether the jump in childhood brain cancer incidence in the mid-1980s may have been related to the rapid decline in the use of aspirin among children in the period between 1980 and 1985 (1). The similar timing of the increase in brain cancer incidence and the decline in aspirin use is likely coincidental for the following reasons: 1) The use of antipyretics in children is almost exclusively episodic and lasts for brief treatment courses during acute infections. On the other hand, the use of aspirin for the prevention of colon adenomas and cancers appears to require prolonged, regular usage over many years (2). 2) While there are well-documented animal models that provide a convincing preclinical rationale for the role of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) as chemopreventive agents for colon cancer (3), there are no animal models that show a preventive effect for aspirin and NSAIDs against brain cancers. 3) Both case-control and cohort epidemiologic studies have revealed a substantial reduction in the risk of colorectal cancer among regular users of aspirin. For example, multiple studies have demonstrated that persons with rheumatoid arthritis, a population that ingests large amounts of aspirin for prolonged periods, have lower than expected rates of colorectal cancer (4). However, epidemiologic studies suggest that the chemopreventive effects of aspirin for colorectal cancer do not apply broadly to other types of cancer (5,6). Specifically, diminished rates of brain cancer have not been reported for patients with rheumatoid arthritis, and some reports have noted a somewhat higher than expected incidence for brain cancer among these patients (6).
Animal models, observational studies, and randomized trials all support the ability of aspirin and NSAIDS to prevent colon cancer (7). Data are not available to support a similar relationship between aspirin and brain cancer. Given the absence of these data and given the limited duration of treatment with antipyretics in children (compared with the treatment periods associated with reduced colon cancer risk), it is unlikely that the sudden increase in the reported incidence of childhood brain cancer in the mid-1980s was related to changing patterns of aspirin use in children.
REFERENCES
1
Arrowsmith JB, Kennedy DL, Kuritsky JN, Faich GA. National
patterns of aspirin use and Reye's syndrome reporting, United States, 1980 to 1985. Pediatrics 1987;79: 858-63.
2
Giovannucci E, Egan KM, Hunter DJ, Stampfer MJ, Colditz GA,
Willett WC, et al. Aspirin and the risk of colorectal cancer in women. N Engl J Med 1995;333:609-14.
3 Moorghen M, Ince P, Finney KJ, Sunter JP, Appleton DR, Watson AJ. A protective effect of sulindac against chemically-induced primary colonic tumours in mice. J Pathol 1988;156:341-7.[CrossRef][ISI][Medline]cancerlit;89141260
4
Heath CW Jr. Rhematoid arthritis, aspirin, and gastrointestinal
cancer [editorial]. J Natl Cancer Inst 1993;85:258-9.
5 Neugut AI, Rosenberg DJ, Ahsan H, Jacobson JS, Wahid N, Hagan M, et al. Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomarkers Prev 1998;7:869-73.[Abstract]cancerlit;99010655
6
Gridley G, McLaughlin JK, Ekbom A, Klareskog L, Adami HO,
Hacker DG, et al. Incidence of cancer among patients with rheumatoid arthritis. J Natl
Cancer Inst 1993;85:307-11.
7 Garay CA, Engstrom PF. Chemoprevention of colorectal cancer: dietary and pharmacologic approaches. Oncology (Huntingt) 1999;13:89-97; discussion 97-100, 105.[Medline]
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