***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Chronic inflammation has been consistently associated with cancers of several sites , including the breast , and inhibition of inflammation through the use of non-steroidal anti-inflammatory drugs ( NSAIDs ) has been inversely associated with risk . As NSAIDs bind with cyclooxygenase-2 ( COX-2 ) , genetic variation in COX-2 may influence breast cancer risk by affecting inflammatory response and response to NSAID use . We identified eight single nucleotide polymorphisms ( SNPs ) for COX-2 and examined their association with  risk of breast cancer in a population -based case – control study in Western New York . Cases had incident , first primary , histologically confirmed breast cancer ( n = 1077 ) . Controls ( n = 1910 ) were r and omly selected from NY Department of Motor Vehicles records ( < 65 ) or Medicare rolls ( ≥65 ) . Participants were queried on adult lifetime use of aspirin and recent use of ibuprofen . Unconditional logistic regression was used to estimate odds ratios ( OR ) and 95 % confidence intervals ( 95 % CI ) . One SNP , rs2745559 , was associated with an increased risk of breast cancer ( OR 1.23 , 95 % CI 1.03–1.46 ) . Associations with other variants were not evident . Significant interaction ( P interaction = 0.04 ) between recent aspirin use and rs4648261 was also observed . Variation in COX-2 was modestly associated with breast cancer risk , indicating that COX-2 may play a role in breast carcinogenesis . Better underst and ing of the role of COX-2 genetic variation and interaction with NSAID use in breast carcinogenesis has potential to inform prevention strategies OBJECTIVE Previous epidemiological studies have suggested that use of aspirin or other nonsteroidal anti-inflammatory drugs ( NSAIDs ) may be associated with reduced risk of breast cancer , but some studies have been limited in their ability to separate the effects of aspirin from other NSAIDs or to account for breast cancer risk factors . METHODS We examined the incidence of breast cancer in association with self-reported aspirin , as well as other nonaspirin NSAID use in a large prospect i ve cohort of postmenopausal women ( n = 27,616 ) . Over 6 years of follow-up , 938 incident breast cancers were identified . RESULTS After adjustment for other breast cancer risk factors , any current use of aspirin or other NSAIDs compared with no use was associated with a reduction in risk of breast cancer [ relative risk ( RR ) = 0.80 , 95 % confidence interval ( CI ) 0.67 - 0.95 ] . There was a trend of decreasing risk of incident breast cancer with increasing frequency of aspirin use ( P(trend ) = 0.0011 ) . The multivariate-adjusted RR of breast cancer was 0.71 ( 95 % CI 0.58 - 0.87 ) for women who reported using aspirin six or more times per week compared with women who reported no use . These results did not depend on whether women had early or late stage breast cancer . No association was found between  nonaspirin NSAID use and incident breast cancer . The adjusted RR of using other NSAIDs six or more times per week compared with no use was 1.01 ( 95 % CI 0.83 - 1.25 ) . CONCLUSION This prospect i ve study corroborates other reports that use of aspirin might reduce risk of breast cancer BACKGROUND The use of aspirin and other nonsteroidal anti-inflammatory drugs ( NSAIDs ) is widespread for treatment of common symptoms such as headaches , muscular pain , and inflammation . In addition , the chemopreventive use of NSAIDs is increasingly common for heart disease and colon cancer . Evidence of a protective association with breast cancer risk has been inconsistent , and few data exist for premenopausal women . METHODS We assessed the associations for use of aspirin , other NSAIDs , and acetaminophen with breast cancer risk among premenopausal women in the prospect i ve Nurses ' Health Study II . In total , 112,292 women , aged 25 to 42 years and free of cancer in 1989 , were followed up until June 2003 .  Multivariate relative risks and 95 % confidence intervals were calculated by Cox proportional hazards models , adjusting for age and other important breast cancer risk factors . RESULTS Overall , 1345 cases of invasive premenopausal breast cancer were documented . Regular use of aspirin ( > or = 2 times per week ) was not significantly associated with breast cancer risk ( relative risk , 1.07 ; 95 % confidence interval , 0.89 - 1.29 ) . Regular use of either nonaspirin NSAIDs or acetaminophen also was not consistently associated with breast cancer risk . Results did not vary by frequency ( days per week ) , dose ( tablets per week ) , or duration of use . Furthermore , associations with each drug category did not vary substantially by estrogen and progesterone receptor status of the tumor . CONCLUSION These data suggest that the use of aspirin , other NSAIDs , and acetaminophen is not associated with a reduced risk of breast cancer among premenopausal women UNLABELLED There is evidence that use of aspirin offers several potential health benefits including cancer prevention and cardiovascular disease prevention . The purpose of this study was to assess the association between aspirin use and death from cancer and cardiovascular diseases with a special emphasis on cancer mortality . MATERIAL S AND METHODS The baseline data for this prospect i ve cohort study were collected in 1971 - -1975 for the first National Health and Nutrition Examination Study ( NHANES I ) and 1976 - -1980 as part of the second NHANES ( NHANES II ) with mortality follow-up using the National Death Index ( NDI ) through December 31 , 1992 . The main analyses were the relative risks of total mortality and cause-specific mortality for persons who used aspirin  compared to persons who did not use aspirin  adjusted for confounding using Cox proportional hazards . RESULTS The proportion of  aspirin users was lower among cancer cases than non-cases ( 58 % versus 66 % ) and use of aspirin decreased with age . Consequently , age was a negative confounder attenuating the protective association between aspirin use and cancer and cardiovascular mortality . After adjusting for age , BMI , sex , race , poverty index , education and smoking , we observed a significant association of reduced all cause mortality among all aspirin users ( relative risk [ RR ] = 0.88 ; 95 % confidence interval [ CI ] 0.85 - 0.99 ) and lung cancer mortality among male aspirin users ( RR = 0.69 ; CI 0.49 - 0.96 ) . However , for women we observed adverse associations between aspirin use and bladder ( RR=12.31 ; CI 2.98 - 50.80 ) and brain cancer mortality ( RR=3.13 ; CI 1.09 - 9.00 ) , although case numbers were small . CONCLUSION Aspirin use appears to offer protection from all causes of mortality and lung cancer among men . In women  aspirin use is associated with increased risk of bladder and brain cancer . Because of the small number of female bladder ( n=15 ) and brain ( n=20 ) cancer cases in this cohort the findings require confirmation BACKGROUND The cancer chemopreventive benefits of aspirin and nonaspirin nonsteroidal anti-inflammatory drugs ( NSAIDs ) are incompletely defined and may vary by smoking history . We evaluated associations between aspirin and nonaspirin NSAID use with cancer incidence and mortality stratified by smoking history in the Iowa Women 's Health Study , a prospect i ve cohort of postmenopausal women . METHODS Aspirin and nonaspirin NSAID use was self-reported by question naire in 1992 . Cancer incidence and mortality were ascertained by annual linkage to the Iowa Surveillance , Epidemiology , and End Results Cancer Registry and death certificates . Cox proportional hazards models were used to estimate multivariable relative risks ( RRs ) and 95 % confidence intervals ( CIs ) . All statistical tests were two-sided . RESULTS During an average of 10 years of follow-up , 3487 incident cancer cases and 3581 deaths were observed in the cohort of 22,507 women . Compared with nonuse , aspirin use was inversely associated with total cancer incidence ( multivariable-adjusted RR = 0.84 , 95 % CI = 0.77 to 0.90 ) , with age-adjusted incidence rates of 147 and 170 per 10,000 person-years for ever and never users , respectively , and was inversely associated with cancer mortality ( multivariable-adjusted RR = 0.87 , 95 % CI = 0.76 to 0.99 ) , with age-adjusted rates of 47 and 52 per 10,000 person-years . The inverse relationship was stronger among former and never smokers than current smokers , although not statistically significantly ( P = .28 ) . Aspirin use was also inversely associated with coronary heart disease mortality ( multivariable-adjusted RR = 0.75 , 95 % CI = 0.64 to 0.89 ) , with age-adjusted rates of 23 and 30 per 10,000 person-years for ever and never users , respectively , and with all-cause mortality ( multivariable-adjusted RR = 0.82 , 95 % CI = 0.76 to 0.89 ) , with age-adjusted rates of 126 and 155 per 10,000 person-years . Nonaspirin NSAID use was not associated with cancer incidence or mortality , coronary heart disease mortality , or all-cause mortality . CONCLUSIONS Aspirin use , but not nonaspirin NSAID use , was associated with lower risks of cancer incidence and mortality , which was more pronounced among former and never smokers than current smokers Nonsteroidal antiinflammatory drugs ( NSAIDs ) may play a role in breast cancer prevention ; however , breast cancer subtypes and lifestyle/host factors may influence their impact . During 1996 - 1998 in Canada , the authors examined the association between regular NSAID use ( defined as daily use for at least 2 months ) and breast cancer risk by estrogen receptor ( ER ) and progesterone receptor ( PR ) status , cigarette smoking exposure , and history of arthritis .  Breast cancer cases ( n = 3,125 , including 1,600 ER+PR+ and 591 ER-PR- ) and an age-matched , r and om sample of controls ( n = 3,062 ) completed a general risk factor question naire , including detailed questions on prescription and nonprescription NSAID use . NSAID use was associated with reduced risk of breast cancer ( odds ratio = 0.76 , 95 % confidence interval : 0.66 , 0.88 ) . The association was not significantly different for ER+PR+ ( odds ratio = 0.71 , 95 % confidence interval : 0.60 , 0.84 ) and ER-PR- cancers ( odds ratio = 0.80 , 95 % confidence interval : 0.62 , 1.03 ) ( p(heterogeneity ) = 0.66 ) . The magnitude of the NSAID inverse association was similar for women with and without arthritis and across smoking strata ( risk estimates ranged from 0.74 to 0.84 ) . Breast cancer risk tended to decrease with increasing duration of NSAID use and was generally lowest for > or=7 years of use , and both acetylsalicylic acid and non-acetylsalicylic acid use were associated with reduced risks We carried out a nested case – control study to measure the rate ratio ( RR ) for invasive female breast cancer in relation to non-steroidal anti-inflammatory drug ( NSAID ) use . The source population consisted of the female beneficiaries of the Saskatchewan Prescription Drug Plan from 1981 to 1995 with no history of cancer since 1970 . Four controls/case , matched on age and sampling time , were r and omly selected . Dispensing rates during successive time periods characterized NSAID exposure . RRs associated with exposure during each period were adjusted for exposure during the others . Confounding by other determinants was studied in analyses adjusted with data obtained by interviewing sample s of subjects accrued from mid-1991 to mid-1995 . We accrued 5882 cases and 23 517 controls . Increasing NSAID exposure 2–5 years preceding diagnosis was associated with a trend towards a decreasing RR ( P -trend = 0.003 ) ; for the highest exposure level RR = 0.76 , 95 % confidence interval 0.63–0.92 . This protective effect could not be attributed to confounding by other determinants . In analyses involving only the cases , NSAID exposure 2–5 and 6–10 years preceding diagnosis was associated with significantly reduced risks of presenting with a large tumour ( > 5 cm diameter ) or distant metastasis , but not regional lymph node metastasis . The use of NSAIDs may retard the growth of breast cancers and prevent distant metastasis . © 2000 Cancer Research Use of non-steroidal anti-inflammatory drugs ( NSAIDs ) 
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A similar effect was found for aspirin , acetaminophen , COX-2 inhibitors and , to a lesser extent , ibuprofen .
The effect of aspirin was similar in preventing hormone-receptor-positive breast cancer .
This meta- analysis suggests a slightly protective effect of NSAIDs-especially aspirin and COX-2 inhibitors- against breast cancer , which seems to be restricted to ER/PR+tumors