A pharmacoepidemiologic assessment of nonsteroidal anti-inflammatory drug exposure and the association withcolorectal cancer, gastrointestinal and renal adverse events
Niecko, Timothy Edward
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INTRODUCTION: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths and is a growing health concern. Recently, epidemiological studies have associated NSAID use with a protective effect against CRC. METHODS: A retrospective, longitudinal, cohort design was used to assess the relationship of NSAID exposure and the incidence of CRC, gastrointestinal (GI), and renal adverse events in a Georgia Medicaid population. RESULTS: Over 700,000 person-years and 1.4 million drug claims were utilized. NSAID exposure reduced the risk of CRC by 25% and a dose/response relationship was confirmed with higher usage conferring more protection. Frequent users of NSAIDs did not experience an increased risk for GI and renal adverse events, though less frequent NSAID use trended toward an increase risk of GI events. CONCLUSION: This study confirms the NSAID/CRC protective relationship and found that long term NSAID use was not associated with an increase in GI and renal adverse events.