{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:54:02Z","timestamp":1754160842511,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T00:00:00Z","timestamp":1751673600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs), particularly acetylsalicylic acid (ASA), have been associated with reduced breast cancer (BCa) mortality. While overexpression of cyclooxygenase\u20102 (COX\u20102) correlates with poorer prognosis in BCa, COX\u20102 inhibitors (coxibs) have not demonstrated a survival advantage. However, the evidence remains conflicting and limited. We examined associations between BCa mortality and NSAID use in a Finnish population\u2010based cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study cohort, 73\u2009170 women with new BCa diagnosis during 1995\u20132013 was identified from The Finnish Cancer Registry. Follow\u2010up data including date and the cause of death, NSAID purchases from 1995 to 2015, mammography screening participation and tumor hormone receptor status, were obtained from national registries. NSAID purchases were categorized into NSAIDs overall, ASA, and coxibs. BCa\u2010specific and overall survival by NSAID use were analyzed using Cox proportional hazard regression, adjusted for age, tumor extent, primary treatment, Charlson comorbidity index, hypertension, diabetes, mammography participation, and hormonal therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pre\u2010diagnostic use of NSAIDs (HR 0.78, 95% CI: 0.75\u20130.81) and coxibs (HR 0.76, 95% CI: 0.71\u20130.81) was associated with reduced BCa mortality, while ASA showed no association. Post\u2010diagnostic NSAID use was associated with increased BCa mortality (HR 1.27, 95% CI: 1.22\u20131.33), while ASA use (HR 0.84, 95% CI: 0.73\u20130.97) showed dose\u2010dependent risk reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Post\u2010diagnostic use of ASA is associated with reduced BCa\u2010specific mortality, distinguishing ASA from other NSAIDs. Clinical trials are required to determine the ideal ASA dose, frequency, and duration for treating BCa. Pre\u2010diagnostic use of NSAIDs overall is associated with a slight reduction in BCa mortality without dose dependence. The potential role of pre\u2010diagnostic NSAID use as a prognostic factor in BCa warrants further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.70271","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T06:55:11Z","timestamp":1751698511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acetyl Salicylic Acid, <scp>COX<\/scp>\u20102 Inhibitors and Other <scp>NSAIDs<\/scp> and Breast Cancer Survival in a Finnish Population\u2010Based Cohort"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2155-8480","authenticated-orcid":false,"given":"M.","family":"Malin","sequence":"first","affiliation":[{"name":"Tampere University Faculty of Medicine and Health Technology  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7922-1444","authenticated-orcid":false,"given":"M.","family":"Murto","sequence":"additional","affiliation":[{"name":"Tampere University Faculty of Medicine and Health Technology  Tampere Finland"},{"name":"Department of General Surgery TAYS Cancer Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Arponen","sequence":"additional","affiliation":[{"name":"Tampere University Faculty of Medicine and Health Technology  Tampere Finland"},{"name":"Department of Oncology TAYS Cancer Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Jukkola","sequence":"additional","affiliation":[{"name":"Tampere University Faculty of Medicine and Health Technology  Tampere Finland"},{"name":"Department of Oncology TAYS Cancer Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7814-427X","authenticated-orcid":false,"given":"A.","family":"Siltari","sequence":"additional","affiliation":[{"name":"Tampere University Faculty of Medicine and Health Technology  Tampere Finland"},{"name":"Department of Pharmacology Faculty of Medicine, University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Artama","sequence":"additional","affiliation":[{"name":"Department of Health Protection Finnish Institute for Health and Welfare  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Visvanathan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Department of Oncology Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-9590","authenticated-orcid":false,"given":"T.","family":"Murtola","sequence":"additional","affiliation":[{"name":"Tampere University Faculty of Medicine and Health Technology  Tampere Finland"},{"name":"Department of Urology TAYS Cancer Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_3_1","first-page":"1188","volume-title":"DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology","author":"DeVita V. 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