Analgesic therapy and the prevention of bladder cancer.

The aim of this study was to measure the association between analgesic use and risk of bladder cancer among patients seen at the James A. Haley Veterans' Administration (VA) Hospital in Tampa, FL. A total of 330 cases were obtained using a combination of computerized pathology records, and inpatient and outpatient diagnoses. Controls were randomly selected from the VA computerized administrative database, and 1293 controls were included for analysis. Unconditional logistic regression analysis was performed to assess the risk of bladder cancer after adjusting for age, gender, and cigarette smoking. Among analgesic users, we were able to identify a nearly 20% reduction in risk potentially consistent with a protective role (OR = 0.81, 95% CI = 0.63, 1.05). Nonsmokers had a 43% decrease in risk (OR = 0.57, 95% CI = 0.33, 0.98). While smoking is a strong and recognized cause of bladder cancer, 50% of bladder cancer cases are not attributable to tobacco consumption. Given that nonsmokers prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) were observed to have a 43% reduction in risk, it is important to study whether nonsmokers may benefit from therapy with NSAIDs.