Results from the VITAL Study on Long-Term Acetaminophen, Aspirin, and Ibuprofen Use

In an article published online on May 9, 2011 in the Journal of Clinical Oncology, a large-scale prospective study found that acetaminophen use was associated with an almost two-fold increased risk of hematological malignancies other than chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) (DOI 10.1200/JCO.2011.34.6346). The study also found that neither aspirin nor nonsteroidal anti-inflammatory drugs (NSAIDs) are useful for preventing hematological malignancies.

Generic regular strength enteric coated 325mg aspirin tablets; source: Wikimedia Commons user Ragesoss

The study aimed to examine the association of over-the-counter analgesics or NSAIDS and the frequency of hematologic malignancies in a prospective and large patient group. Previous study results were not consistent for NSAIDs but did suggest an increased risk of disease with acetaminophen use.

Roland B. Walter and his colleagues at the Fred Hutchinson Cancer Research Center and the University of Washington analyzed a total of 64,839 men and women between the ages of 50 and 76 years. These patients were recruited over a two-year span from 2000 to 2002 for the Vitamins and Lifestyle (VITAL) study. All analyses were adjusted for age; sex; race; education; smoking; arthritis; migraines; headaches; and family history of hematologic malignancies such as leukemia and lymphoma, among others.

The results of the analysis showed an increased risk of hematologic malignancies associated with high use (more than 4 days a week for more than 4 years) of acetaminophen (hazard ratio = 1.84, P = .004). The association was seen for myeloid neoplasms, non-Hodgkin lymphomas, and plasma cell disorders. There was no association of high acetaminophen use with CLL/SLL.

The study did not find an association of hematologic malignancy risk with aspirin, ibuprofen, or nonaspirin NSAIDs.