Table 2.
Association between nonsteroidal anti-inflammatory drug use and incident melanoma in the Vitamins and Lifestyle cohort (2000–2005)
| Characteristic | Cohort, No. (%) | Patients, No. (%) | Age- and sex-adjusted HR (95% CI) | Multivariable-adjusted HR (95% CI)* |
| Any NSAID use† | ||||
| Overall use | ||||
| None‡ | 23 303 (37) | 123 (35) | 1.00 (referent) | 1.00 (referent) |
| Ever | 40 506 (63) | 226 (65) | 0.99 (0.79 to 1.23) | 0.99 (0.79 to 1.25) |
| Duration of use in past 10 y, y | ||||
| None‡ | 23 303 (37) | 123 (35) | 1.00 (referent) | 1.00 (referent) |
| 1–3 | 12 745 (20) | 63 (18) | 0.91 (0.67 to 1.23) | 0.92 (0.67 to 1.25) |
| 4–8 | 12 096 (19) | 69 (20) | 0.99 (0.73 to 1.33) | 0.99 (0.73 to 1.35) |
| 9–10 | 15 665 (25) | 94 (27) | 1.05 (0.80 to 1.38) | 1.07 (0.80 to 1.41) |
| Dose, average days per week of use during 10 y§ | ||||
| None‡ | 23 303 (37) | 123 (35) | 1.00 (referent) | 1.00 (referent) |
| >0 to 3 | 24 216 (38) | 116 (33) | 0.91 (0.70 to 1.17) | 0.92 (0.71 to 1.19) |
| ≥4 | 16 290 (26) | 110 (32) | 1.10 (0.85 to 1.43) | 1.12 (0.84 to 1.48) |
| NSAID use excluding low-dose aspirin | ||||
| Overall use | ||||
| None‡ | 23 303 (43) | 123 (42) | 1.00 (referent) | 1.00 |
| Ever | 31 391 (57) | 173 (58) | 1.01 (0.80 to 1.27) | 1.02 (0.80 to 1.31) |
| Duration (years of use in past 10 y) | ||||
| None‡ | 23 303 (42) | 123 (41) | 1.00 (referent) | 1.00 (referent) |
| 1–3 | 10 606 (19) | 56 (19) | 0.98 (0.72 to 1.35) | 1.00 (0.73 to 1.39) |
| 4–8 | 9062 (16) | 49 (16) | 0.98 (0.70 to 1.36) | 0.99 (0.70 to 1.39) |
| 9–10 | 12 042 (22) | 70 (23) | 1.05 (0.78 to 1.41) | 1.06 (0.78 to 1.45) |
| Dose (average days per week of use during 10 y)‡ | ||||
| None‡ | 23 303 (43) | 123 (42) | 1.00 (referent) | 1.00 (referent) |
| >0 to 3 | 20 881 (38) | 109 (37) | 1.00 (0.77 to 1.30) | 1.02 (0.78 to 1.33) |
| ≥4 | 10 510 (19) | 64 (22) | 1.02 (0.75 to 1.38) | 1.03 (0.74 to 1.43) |
| Regular- or extra-strength aspirin‖ | ||||
| Overall use | ||||
| None‡ | 23 303 (58) | 123 (57) | 1.00 (referent) | 1.00 (referent) |
| Ever | 16 606 (42) | 93 (43) | 0.93 (0.71 to 1.23) | 0.97 (0.73 to 1.30) |
| Duration (years of use in past 10 y) | ||||
| None‡ | 23 303 (58) | 123 (57) | 1.00 (referent) | 1.00 (referent) |
| 1–3 | 4661 (12) | 23 (11) | 0.85 (0.54 to 1.33) | 0.88 (0.56 to 1.39) |
| 4–8 | 4558 (11) | 30 (14) | 1.07 (0.71 to 1.60) | 1.12 (0.74 to 1.70) |
| 9–10 | 7651 (19) | 41 (19) | 0.89 (0.62 to 1.27) | 0.93 (0.64 to 1.35) |
| Dose (average days per week of use during 10 years)§ | ||||
| None‡ | 23 303 (58) | 123 (57) | 1.00 (referent) | 1.00 (referent) |
| >0 to 3 | 9449 (24) | 45 (21) | 0.86 (0.61 to 1.21) | 0.88 (0.62 to 1.25) |
| ≥4 | 7157 (18) | 48 (22) | 1.02 (0.73 to 1.44) | 1.10 (0.76 to 1.58) |
| Nonaspirin NSAID use¶ | ||||
| Overall use | ||||
| None‡ | 23 303 (52) | 123 (51) | 1.00 (referent) | 1.00 (referent) |
| Ever | 21 161 (48) | 116 (49) | 1.08 (0.84 to 1.39) | 1.12 (0.85 to 1.49) |
| Duration (years of use in past 10 y) | ||||
| None‡ | 23 303 (52) | 123 (51) | 1.00 (referent) | 1.00 (referent) |
| 1–3 | 9849 (22) | 55 (23) | 1.06 (0.77 to 1.46) | 1.12 (0.80 to 1.57) |
| 4–8 | 6119 (14) | 28 (12) | 0.90 (0.60 to 1.36) | 0.93 (0.61 to 1.43) |
| 9–10 | 5564 (12) | 37 (15) | 1.38 (0.96 to 2.00) | 1.42 (0.97 to 2.08) |
| Dose (average days per week of use during 10 y)‡ | ||||
| None‡ | 23 303 (52) | 123 (51) | 1.00 (referent) | 1.00 (referent) |
| >0 to 3 | 17 328 (39) | 94 (39) | 1.07 (0.82 to 1.40) | 1.11 (0.83 to 1.48) |
| ≥4 | 3833 (9) | 22 (9) | 1.14 (0.72 to 1.80) | 1.22 (0.75 to 1.99) |
Adjustments were for age at baseline (timescale), sex (female or male), education (high school or fewer than 12 years, some college, or advanced degree), first-degree family history of melanoma (no or yes), personal history of nonmelanoma skin cancer (no or yes), ever had moles removed (no or yes), freckles between ages 10 and 20 years (no or yes), had three or more severe sunburns between ages 10 and 20 years (no or yes), natural red or blond hair between ages 10 and 20 years (no or yes), reaction to 1 hour in strong sunlight (tan or no sunburn, mild burning, painful sunburn, or severe sunburn with blistering), multivitamin use (none, <0 to 3, or ≥4 d/wk), chronic pain in last year (no or yes), arthritis (no or yes), cardiovascular disease (no or yes), and kidney disease or ulcer (no or yes). HR = hazard ratio; CI = confidence interval; NSAID = nonsteroidal anti-inflammatory drug.
Any NSAID use was defined as report of regular use of low-dose aspirin, regular- or extra-strength aspirin, or non-aspirin NSAIDs (ibuprofen, naproxen, or celecoxib or rofecoxib or, for women only, other prescription NSAIDs).
Nonusers of any NSAID (low-dose aspirin, regular- or extra-strength aspirin, or non-aspirin NSAIDs [ibuprofen, naproxen, or celecoxib or rofecoxib or, for women only, other prescription NSAIDs]) were the common reference for all exposure groups.
Dose for each exposure was computed as (days per week of use) multiplied by (years of use divided by 10 years).
Users of NSAIDs other than regular- or extra-strength aspirin were excluded from the referent group.
Users of aspirin were excluded from the referent group.