Long-term use of acetaminophen, aspirin, and other nonsteroidal anti-inflammatory drugs and risk of hematologic malignancies: Results from the Prospective Vitamins and Lifestyle (VITAL) study
Journal of Clinical Oncology, 05/16/2011

Walter RB et al. – High use of acetaminophen was associated with an almost two-fold increased risk of incident hematologic malignancies other than CLL/SLL. Neither aspirin nor nonaspirin NSAIDs are likely useful for prevention of hematologic malignancies.

• 64,839 men and women age 50 to 76 years recruited from 2000 to 2002 to Vitamins and Lifestyle (VITAL) study
• Incident hematologic malignancies (n = 577) identified through December 2008 by linkage to Surveillance, Epidemiology and End Results cancer registry
• HR associated with use of analgesics for total incident hematologic malignancies and cancer subcategories estimated by Cox proportional hazards models
• Models adjusted for age, sex, race/ethnicity, education, smoking, self-rated health, arthritis, chronic musculoskeletal pain, migraines, headaches, fatigue, and family history of leukemia/lymphoma

• Increased risk of incident hematologic malignancies associated with high use (≥ 4 days/week for ? 4 years) of acetaminophen (HR, 1.84; 95% CI, 1.35 to 2.50 for high use; P trend = .004)
• Association seen for myeloid neoplasms (HR, 2.26; 95% CI, 1.24 to 4.12), non-Hodgkin's lymphomas (HR, 1.81; 95% CI, 1.12 to 2.93), and plasma cell disorders (HR, 2.42; 95% CI, 1.08 to 5.41), but not chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; HR, 0.84; 95% CI, 0.31 to 2.28)
• No association with risk of incident hematologic malignancies for increasing use of aspirin, nonaspirin NSAIDs, or ibuprofen