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Health & Medicine for Senior Citizens

Long-Term Use of Nonaspirin Anti-inflammatory Drugs Linked to Renal Cell Cancer

Pain relievers popular with senior citizens for pain relief, cancer protection

Sept. 13, 2011 - Long-term use of nonaspirin anti-inflammatory drugs (NSAIDs) is associated with an increased risk of renal cell cancer (RCC), according to a report in the September issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

According to background information in the article, in the United States, kidney cancer is the seventh leading type of cancer among men and the ninth leading type of cancer among women. The most common type of kidney cancer, renal cell cancer (RCC), accounts for 85 percent of all cases.

Analgesics (pain-relieving medications) are among the most commonly used groups of drugs in the United States, and some appear to have protective effects against cancer.

In one survey, acetaminophen, ibuprofen, and aspirin were the three most commonly used prescription and over-the-counter drugs; those drugs are considered by the World Health Organization as "essential medicines."

One survey found that among people aged 57 to 85, 28% take aspirin and 8 percent take acetaminophen. Aspirin and, to some extent, other NSAIDs, are not just used for pain relief, however, but also for well-established protective effect against cardiovascular disease and colorectal cancer.


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"However," the authors write, "some epidemiologic data, mainly from case-control studies, suggest an association between analgesic use and an increased risk of RCC."

Eunyoung Cho, Sc.D., from Harvard Medical School and Brigham and Women's Hospital, Boston, and colleagues examined the relationship between analgesic use and RCC risk. They used data from the Nurses' Health Study and the Health Professionals Follow-up Study, both prospective cohort studies.

Beginning in 1990 in the Nurses' Health Study and 1986 in the Health Professionals Follow-up Study, and every two years thereafter, use of aspirin, other NSAIDs and acetaminophen was determined. Follow-up was 16 years and 20 years, respectively.

The researchers evaluated the baseline and duration of use of analgesics. They also assessed other risk factors for RCC, such as body weight, smoking, recreational physical activity and history of hypertension.

Among the 77,525 women and 49,403 men included in the study, the researchers documented 333 RCC cases. No association was found between aspirin and acetaminophen (Tylenol) use and RCC risk.

An association was found between regular use of nonaspirin NSAIDs and an increased risk of RCC, with a 51 percent increase in the relative risk.

The researchers noticed a dose-response relationship between duration of nonaspirin NSAID use and RCC risk; there was a 19 percent decrease in relative risk for use less than four years, a 36 percent increase in relative risk for use of analgesics for four years to less than 10 years and nearly three times the relative risk for use for 10 or more years.

"In these large prospective studies of women and men, we found that use of nonaspirin NSAIDs was associated with an elevated risk of RCC, especially among those who took them for a long duration," write the authors, who add that aspirin and acetaminophen were not associated with RCC risk.

"Risks and benefits should be considered in deciding whether to use analgesics; if our findings are confirmed, an increased risk of RCC should also be considered."

This study was supported by research grants from the National Institutes of Health, the Kidney Center Association and the Dana-Farber/Harvard Cancer Center Kidney Cancer Specialized Programs of Research Excellence.

Consumer Reports Recommendations - NSAIDs

About Pain Relievers

Also called: Analgesics, Pain medicines

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis or any number of other aches and pains.

There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

Over-the-counter (OTC) medicines are good for many types of pain.

There are two main types of OTC pain medications: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve) and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.

If OTC medicines don't relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are available at prescription doses.

The most powerful pain relievers are narcotics. These drugs can have serious side effects. You must use them only under a doctor's supervision.

There are many things you can do to help ease pain. Pain relievers are just one part of a pain treatment plan.

>> More at MedlinePlus

NSAIDs block the production of substances in the body called prostaglandins, which play a role in pain, inflammation, fever, and muscle cramps and aches. At low doses, they work essentially as pain relievers. At higher doses, though, they can reduce the body’s inflammatory response to tissue damage as well as relieve pain.

 All NSAIDs are effective pain relievers. No NSAID has clearly been shown to be more effective than the others.

NSAIDs differ substantially in price, so cost might be an important factor in which one you choose.

 Taking effectiveness, safety, and cost into account, we have chosen two NSAIDs as Consumer Reports Health Best Buy Drugs:

  ● Ibuprofen – (generic only) prescription and over-the-counter

  ● Naproxen – (Aleve and generic) prescription and over-the-counter

 These medicines are inexpensive and as effective and safe as other NSAIDs when used appropriately. Both are available as both prescription and non-prescription drugs.

 But be aware: many cough and cold combination products contain ibuprofen, naproxen, or acetaminophen.

If you already take an NSAID for pain and need to take a cold remedy, check to make sure it does not interact with your NSAID and that you are not exceeding the maximum daily amount for the particular NSAID.

 This report was published in March 2011. Click Here to full report Treating Osteoarthritis and Pain, at Consumer Reports,, Best Buy Drugs



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