Painkillers protect against oral cancer in smokers

A class of painkillers - nonsteroidal anti-inflammatory drugs or NSAIDs - cuts the risk Oral cancer in active, moderate cigarette smokers by about half, according to study findings released today during the meeting of the American Association for Cancer Research.

However, this reduction in oral cancer incidence apparently did not translate into increased overall survival.

"Much to our surprise, we found that long-term daily NSAID use for several years or more was associated with a doubling in the risk of cardiovascular death," Dr. Jon Sudbo, from the Norwegian Radium Hospital in Oslo, said during a press briefing Monday.

NSAIDs have previously been shown to protect against colon and breast cancer, but it is not known whether they have the potential to prevent oral cancer.

To investigate, Sudbo and colleagues studied data from the Norwegian Institute of Public Health and the Norwegian Cancer Registry.

Among 3,233 individuals at high risk of Oral cancer based on their tobacco habits, 454 developed cancer of the oral cavity. These individuals were matched by age and sex to 454 cancer-free "controls."

Of the group as a whole, 263 were long-term NSAID users and 645 were not. A total of 77 patients with oral cancer were NSAID users compared to 186 without oral cancer.

Long-term use was defined as taking NSAIDs daily for at least 6 months, and most of the NSAID users in the study had been taking these drugs for 5 years or more.

The likelihood of developing oral cancer with long-term NSAID use was a "highly significant" 51 percent lower compared with not taking NSAIDs, Sudbo said.

Acetaminophen (paracetamol), which is not in the NSAID class, had no apparent protective effects.

However, the likelihood of dying of cardiovascular disease was doubled with long-term use of any NSAID, Sudbo reported. "This is a small study of a special population but it raises the question of safety in chemopreventive trials of NSAIDs," he warned, adding that clearly more study is needed.