Michael Cook

HREB/DCEG/NCI

Investigator

PLCO (Learn more about this study)

PLCO-136

Mar 13, 2015

Pre- and Post-diagnostic NSAID Use and Prostate Cancer Mortality among Prostate Cancer Cases

Prostate cancer is the second leading cause of cancer death in U.S. men. Identifying modifiable factors for prostate cancer progression and survival is of particular interest, given the high likelihood (~1/6) of being diagnosed with this malignancy in the PSA era. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been hypothesized to slow prostate cancer progression. However, results from prior epidemiological studies on the association of NSAID use with prostate cancer-specific mortality (PCSM) and the relevant time-window of exposure remain unclear. Therefore, we propose a prospective analysis in the PLCO cohort to examine the association of pre- and post-diagnostic NSAID use with PCSM and all-cause mortality.

All PLCO men diagnosed with first primary prostate cancers after the completion of BQM will be considered for the pre-diagnostic analyses. Pre-diagnostic NSAID use were collected from BQM and/or SQX. A subset of men who were diagnosed after BQM and survived long enough to complete SQX will be considered for the post-diagnostic analyses with NSAID information collected from SQX. Covariates of interest include but are not limited to age at diagnosis; year of diagnosis; race/ethnicity; family history of prostate cancer; education; cholesterol-lowering drug use; weight and height; tobacco; alcohol; physical activity; finasteride use; history of comorbidity including diabetes, heart attack and stroke; PSA at diagnosis; tumor stage; Gleason score; and initial treatment.

We will use adjusted Cox proportional hazards regression models with time since diagnosis as the underlying time metric to estimate HRs and 95%CIs. Age will be used as the underlying time metric for a sensitivity analysis. We will also stratify analyses by tumor stage, Gleason score, and D’Amico risk categories. For pre-diagnostic analyses, follow-up will start at the date of cancer diagnosis. For post-diagnostic analyses, follow-up time will start at the date of SQX completion. For both analyses herein, follow-up will continue until death or the date of the most recent follow-up.