Low-Dose Aspirin or Nonsteroidal Anti-inflammatory Drug Use and Colorectal Cancer Risk A Population-Based, Case-Control Study
Low-Dose Aspirin or Nonsteroidal Anti-inflammatory Drug Use and Colorectal Cancer Risk A Population-Based, Case-Control Study
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DOI：
10.7326/m15-0039
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发表时间：
2015-09-01
影响因子：
39.2
通讯作者：
Sorensen, Henrik T.
中科院分区：
文献类型：
--
作者：
Friis, Soren;Riis, Anders H.;Sorensen, Henrik T.
背景：最近的一项综合综述得出结论，需要进一步的研究来确定预防癌症的最佳阿司匹林。目的：评估小剂量阿司匹林或其他非类固醇抗炎药(NSAID)的使用与结直肠癌风险之间的关系。设计：基于人群的病例对照研究。地点：丹麦北部。患者：1994-2011年间丹麦北部的首次结直肠癌患者。人群控制参与者是通过风险集抽样选择的。测量：从处方和患者登记中获得关于药物使用、合并疾病和结肠镜检查病史的数据。根据小剂量阿司匹林(75~150 mg)和非阿司匹林非类固醇抗炎药的使用类型、估计剂量、持续时间和使用的一致性进行定义。结果：在10280名病例和102 800名对照组中，曾经使用过2种处方的小剂量阿司匹林和非阿司匹林非类固醇抗炎药与结直肠癌的调整优势比(OR)分别为1.03(95%CI，0.98~1.09)和0.94(CI，0.90~0.98)。长期连续使用小剂量阿司匹林(>；=5年)与降低27%的结直肠癌风险相关(OR，0.73[CI，0.54至0.99])，而长期累积使用(连续或非连续)的总体OR接近于1。非阿司匹林非甾体抗炎药的使用与结直肠癌风险的显著降低有关，特别是长期、高强度使用(平均限定日剂量和GT；=0.3)具有高环氧合酶-2选择性的药物(OR，0.57[CI，0.44至0.74])。限制：没有关于非处方药购买高剂量阿司匹林和低剂量布洛芬或非类固醇抗炎药剂量计划的数据，有几个比较，作者无法调整一些危险因素的混淆。结论：长期、持续使用低剂量阿司匹林和长期使用非阿司匹林非类固醇抗炎药与降低结直肠癌风险有关。持续使用低剂量阿司匹林的人只占低剂量阿司匹林使用者的一小部分。
Background: A recent comprehensive review concluded that additional research is needed to determine the optimal use of aspirin for cancer prevention.Objective: To assess associations between the use of low-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) and colorectal cancer risk.Design: Population-based, case-control study.Setting: Northern Denmark.Patients: Patients with first-time colorectal cancer in northern Denmark between 1994 and 2011. Population control participants were selected by risk set sampling.Measurements: Data on drug use, comorbid conditions, and history of colonoscopy were obtained from prescription and patient registries. Use of low-dose aspirin (75 to 150 mg) and nonaspirin NSAIDs was defined according to type, estimated dose, duration, and consistency of use.Results: Among 10 280 case patients and 102 800 control participants, the adjusted odds ratios (ORs) for colorectal cancer associated with ever use (2 prescriptions) of low-dose aspirin and nonaspirin NSAIDs were 1.03 (95% Cl, 0.98 to 1.09) and 0.94 (Cl, 0.90 to 0.98), respectively. Continuous long-term use (>= 5 years) of low-dose aspirin was associated with a 27% reduction in colorectal cancer risk (OR, 0.73 [Cl, 0.54 to 0.99]), whereas the overall OR for cumulative long-term use (continuous or non-continuous) was close to unity. Nonaspirin NSAID use was associated with a substantial reduction in colorectal cancer risk, particularly for long-term, high-intensity use (average defined daily dose >= 0.3) of agents with high cyclooxygenase-2 selectivity (OR, 0.57 [Cl, 0.44 to 0.74]).Limitations: Data were unavailable on over-the-counter purchases of high-dose aspirin and low-dose ibuprofen or NSAID dosing schedules, there were several comparisons, and the authors were unable to adjust for confounding by some risk factors.Conclusion: Long-term, continuous use of low-dose aspirin and long-term use of nonaspirin NSAIDs were associated with reduced colorectal cancer risk. Persons who continuously used low-dose aspirin comprised only a small proportion of the low-dose aspirin users.