Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health-AARP Diet and Health Study.
Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health-AARP Diet and Health Study.
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DOI：
10.1186/bcr2089
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Brinton LA
中科院分区：
文献类型：
--
作者：
Gierach GL;Lacey JV Jr;Schatzkin A;Leitzmann MF;Richesson D;Hollenbeck AR;Brinton LA
通过抑制环氧合酶-2，非甾体抗炎药（NSAID）降低芳香酶活性，并可能通过抑制雌激素合成来降低乳腺癌风险。然而，非甾体抗炎药在乳腺癌中的保护作用的流行病学证据是不明确的。我们在美国国立卫生研究院-美国退休人员协会饮食与健康研究中测试了NSAID的使用与乳腺癌发病率的关系，其中127，383名年龄在51至72岁之间的无癌症史的美国退休人员协会（以前称为美国退休人员协会）女性成员完成了邮寄问卷（1996年至1997年）。我们使用多变量考克斯比例风险回归模型估计了非甾体抗炎药暴露导致乳腺癌的相对风险。截至2003年12月31日，国家癌症登记和死亡率指数联系确定了4 501例原发性乳腺癌，包括1 439例雌激素受体阳性癌症和280例雌激素受体阴性癌症。比例风险模型显示，总体NSAID与总乳腺癌之间无统计学显著相关性。由于阿司匹林（但不是其他非甾体抗炎药）对环氧合酶的抑制是不可逆转的，因此我们按非甾体抗炎药类型测试了相关性。虽然我们没有观察到日常使用的风险有显著差异，（与不使用）阿司匹林（相对风险= 0.93，95%置信区间= 0.85 - 1.01）或非阿司匹林NSAIDS（相对风险= 0.96，95%置信区间= 0.87 - 1.05），每日服用阿司匹林可显著降低ER阳性乳腺癌的风险（相对风险= 0.84，95%可信区间= 0.71 - 0.98）--非阿司匹林类NSAIDS未观察到这种关系。阿司匹林和非阿司匹林NSAID均与ER阴性乳腺癌风险无关。乳腺癌风险与NSAID的使用无显著相关性，但每日使用阿司匹林与ER阳性乳腺癌的适度减少相关。我们的研究结果为进一步评估NSAID类型和乳腺癌亚型之间的关系提供了支持。
By inhibiting cyclooxygenase-2, nonsteroidal anti-inflammatory drugs (NSAIDs) decrease aromatase activity and might reduce breast cancer risk by suppressing estrogen synthesis. Epidemiologic evidence for a protective role of NSAIDs in breast cancer, however, is equivocal. We tested NSAID use for its association with breast cancer incidence in the National Institutes of Health–AARP Diet and Health Study, where 127,383 female AARP (formerly known as the American Association of Retired Persons) members with no history of cancer, aged 51 to 72 years, completed a mailed questionnaire (1996 to 1997). We estimated relative risks of breast cancer for NSAID exposures using multivariate Cox proportional hazards regression models. The state cancer registry and mortality index linkage identified 4,501 primary incident breast cancers through 31 December 2003, including 1,439 estrogen receptor (ER)-positive cancers and 280 ER-negative cancers. Proportional hazards models revealed no statistically significant association between overall NSAIDs and total breast cancer. As cyclooxygenase inhibition by aspirin (but not other NSAIDs) is irreversible, we tested associations by NSAID type. Although we observed no significant differences in risk for daily use (versus nonuse) of aspirin (relative risk = 0.93, 95% confidence interval = 0.85 to 1.01) or nonaspirin NSAIDS (relative risk = 0.96, 95% confidence interval = 0.87 to 1.05), risk of ER-positive breast cancer was significantly reduced with daily aspirin use (relative risk = 0.84, 95% confidence interval = 0.71 to 0.98) – a relationship not observed for nonaspirin NSAIDS. Neither aspirin nor nonaspirin NSAIDs were associated with risk of ER-negative breast cancer. Breast cancer risk was not significantly associated with NSAID use, but daily aspirin use was associated with a modest reduction in ER-positive breast cancer. Our results provide support for further evaluating relationships by NSAID type and breast cancer subtype.
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DOI：
10.1186/bcr1678
发表时间：
2007
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Howe LR
通讯作者：
Howe LR
影响因子：
5.1
作者：
HARRIS, RE;NAMBOODIRI, K;WYNDER, EL
通讯作者：
WYNDER, EL
影响因子：
120.7
作者：
Cook, NR;Lee, IM;Buring, JE
通讯作者：
Buring, JE
影响因子：
5
作者：
Kirsh, Victoria A.;Kreiger, Nancy;Theis, Beth
通讯作者：
Theis, Beth
DOI：
10.1093/jnci/88.14.988
发表时间：
1996-07-17
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Egan, KM;Stampfer, MJ;Colditz, GA
通讯作者：
Colditz, GA