A nationwide study of aspirin, other non-steroidal anti-inflammatory drugs, and Hodgkin lymphoma risk in Denmark

BACKGROUND: We recently found an inverse association between low-dose aspirin use and risk of Hodgkin lymphoma (HL) in northern Denmark. To strengthen the evidence for this association, we expanded the study base to include all of Denmark. METHODS: Between 1997 and 2009, 1659 incident HL cases were identified in nationwide databases and matched with <= 5 population controls on age, sex, and residence. Use of aspirin, selective cyclooxygenase-2 (sCOX-2) inhibitors, and other nonsteroidal anti-inflammatory drugs (NSAIDs) from 1995 through 2008 (>= 1 year before the index date) was ascertained via the Danish National Prescription Database. Odds ratios (ORs) for associations with HL risk were estimated using conditional logistic regression. RESULTS: Ever use (>2 prescriptions) vs never/rare use (<= 2 prescriptions) of low-dose aspirin was not associated with HL risk, but the association with long-term use for >= 7 years vs never/rare use was clearly inverse, although statistically nonsignificantly so (OR 0.65, 95% confidence interval (CI): 0.39-1.09). By contrast, ever use of sCOX-2 inhibitors or other NSAIDs (OR 1.27, 95% CI: 1.10-1.47), especially short-term and low-or medium-intensity use, was associated with elevated HL risk. CONCLUSION: Our results are consistent with the hypothesis that long-term use of low-dose aspirin, but not other NSAIDs, protects against HL development. British Journal of Cancer (2011) 105, 1776-1782. doi:10.1038/bjc.2011.443 www.bjcancer.com