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Title: Non steroidal anti-inflammatory drugs (NSAIDs) and neoplasms in women : trends, risk and progression
Author: Glover , Janine Avril
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2013
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Non steroidal anti -inflammatory drugs (NSAIDs) inhibit the cyclooxygenase enzymes (COX-l and COX-2) and are commonly used to treat pain and inflammation. Recent evidence suggests that COX- 2 inhibition may beneficially influence a range of molecular processes involved in carcinogenesis. This thesis investigated the role of NSAlDs in risk or progression of breast and cervical neoplasms. A systematic review showed high prevalence of COX-2 expression in pre-malignant and invasive breast cancer, indicating involvement of COX-2 in early stage breast cancer carcinogenesis and suggesting that NSAIDs may have the potential to prevent breast cancer development. A study of trends in the diagnosis of carcinoma in situ (CIS) of the breast (pre-invasive disease) in the United Kingdom and Republic of Ireland showed substantial increases in diagnosis rates in both countries indicating an increasing opportunity to prevent invasive breast cancer through the use of chemopreventive agents such as NSAIDs. A study of post-diagnostic NSAID exposure among breast cancer patients, undertaken within the General Practice Research Database (GPRD), showed that NSAID use was associated with an increased risk of breast cancer death and all-cause mortality. These findings may be confounded by indication for use, i.e. patients with more extensive cancer may use NSAIDs for symptom control and also have a poorer prognosis. There was no evidence that use of NSAIDs prevented breast cancer progression. COX-2 has been shown to be over expressed in cervical intraepithelial neoplasia (eIN) and NSAIDs may protect against this premalignant state. The association between NSAID exposure and risk of eIN III was explored. also within the GPRD, but no association was observed. The studies undertaken within this thesis did not provide evidence for a beneficial effect of NSAIDs on neoplasia development or progression but as these drugs are frequently used, and generally well tolerated, further research in this area is warranted.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available