Although many studies have examined the role of chronic inflammation in cancer development, few studies discuss the patterns of acute inflammation prior to cancer diagnosis. Patients with lung, colorectal, prostate, or breast cancer between 1 July 2006 and 31 December 2009 and their metastatic status at diagnosis were determined through the Swedish Cancer Register. Non-steroidal anti-inflammatory drugs (NSAIDs) use in the year prior to cancer diagnosis was assessed through the Swedish Prescribed Drug Register. There were 13,945 patients identified with breast cancer, 6501 with prostate cancer, 5508 with lung cancer, and 12,723 with colon cancer. For metastatic patients, there is strong evidence of higher NSAIDs use 1-3 months compared to 10-12 months prior to diagnosis (breast odds ratio (OR) = 3.54, 95% CI 2.26-5.54; prostate OR = 3.90, 95% CI 3.10-4.90; lung OR = 2.90 95% CI 2.44-3.44; colorectal OR = 1.67, 95% CI 1.36-2.05). For non-metastatic patients, increased NSAIDs use 1-3 months prior to diagnosis was also observed, but only to a smaller extent for lung and prostate cancer (prostate OR = 1.48, 95% CI 1.27-1.72; lung 1.41, 95% CI 1.19-1.67). In conclusion, if NSAIDs use reflects underlying inflammatory symptoms, there is support for the hypothesis that advanced cancer was associated with an acute inflammatory process.