ASPIRIN USE AND REDUCED RISK OF FATAL COLON CANCER
ASPIRIN USE AND REDUCED RISK OF FATAL COLON CANCER
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DOI：
10.1056/nejm199112053252301
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发表时间：
1991-12-05
影响因子：
158.5
通讯作者：
HEATH, CW
中科院分区：
文献类型：
--
作者：
THUN, MJ;NAMBOODIRI, MM;HEATH, CW
研究背景与方法。动物实验和两项人类流行病学研究表明，阿司匹林和其他非甾体抗炎药（NSAIDs）可能对结肠癌有保护作用。我们在一项对662424名成年人进行的前瞻性死亡率研究中检验了这一假设，这些成年人在1982年提供了阿司匹林使用频率和持续时间的信息。结肠癌的死亡率一直测量到1988年。通过对598例患者和3058名对照者的多变量分析，研究了其他风险因素对结肠癌的可能影响。男性和女性服用阿司匹林越频繁，结肠癌的死亡率就越低。每月服用阿司匹林16次或以上至少一年的患者的相对风险在男性中为0.60(95%可信区间，0.40至0.89)，在女性中为0.58（95%可信区间，0.37至0.90）。当我们排除那些在进入研究时报告患有癌症、心脏病、中风或其他可能影响阿司匹林使用和死亡率的疾病的人时，风险估计不受影响。调整饮食因素、肥胖、体育活动和家族史并没有显著改变研究结果。没有发现使用对乙酰氨基酚和结肠癌风险之间的联系。定期服用低剂量的阿司匹林可以降低患致命结肠癌的风险。这是否由于阿司匹林的直接作用（可能是通过抑制前列腺素合成介导的），或者与阿司匹林使用间接相关的其他因素，目前尚不清楚。
Background and Methods. Experiments in animals and two epidemiologic studies in humans suggest that aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) may be protective against colon cancer. We tested this hypothesis in a prospective mortality study of 662,424 adults who provided information in 1982 on the frequency and duration of their aspirin use. Death rates from colon cancer were measured through 1988. The possible influence of other risk factors for colon cancer was examined in multivariate analyses for 598 case patients and 3058 matched control subjects drawn from the cohort.Results. Death rates from colon cancer decreased with more frequent aspirin use in both men and women. The relative risk among persons who used aspirin 16 or more times per month for at least one year was 0.60 in men (95 percent confidence interval, 0.40 to 0.89) and 0.58 in women (95 percent confidence interval, 0.37 to 0.90). The risk estimates were unaffected when we excluded persons who reported at entry into the study that they had cancer, heart disease, stroke, or another condition that might influence both their aspirin use and their mortality. Adjustment for dietary factors, obesity, physical activity, and family history did not alter the findings significantly. No association was found between the use of acetaminophen and the risk of colon cancer.Conclusions. Regular aspirin use at low doses may reduce the risk of fatal colon cancer. Whether this is due to a direct effect of aspirin, perhaps mediated by the inhibition of prostaglandin synthesis, or to other factors indirectly associated with aspirin use is unclear.