Reduced risk of colorectal cancer among long-term users of aspirin and nonaspirin nonsteroidal antiinflammatory drugs
Reduced risk of colorectal cancer among long-term users of aspirin and nonaspirin nonsteroidal antiinflammatory drugs
复制标题
DOI：
10.1097/00001648-200101000-00015
复制
发表时间：
2001-01-01
期刊：
影响因子：
5.4
通讯作者：
Huerta-Alvarez, C
中科院分区：
文献类型：
--
作者：
Rodríguez, LAG;Huerta-Alvarez, C
非甾体抗炎药（NSAIDs）的使用与结直肠癌风险降低相关，但关于个体非阿司匹林类NSAIDs的作用信息有限。此外，阿司匹林降低结直肠癌风险的剂量 - 反应关系尚未阐明。我们开展了一项基于人群的队列研究，并进行了二次病例对照分析，以确定结直肠癌风险与阿司匹林及个体NSAIDs使用之间的关联，包括剂量和持续时间的作用。英国的全科医学研究数据库是源人群。我们追踪了1994年1月至1997年9月期间943,903名年龄在40 - 79岁且无癌症及结直肠腺瘤的人。共确定了2,002例结直肠癌新发病例。每10,000人 - 年的结直肠癌发病率为7.3。非阿司匹林类NSAIDs使用者的结直肠癌风险降低，且在连续治疗6个月后明显显现。调整后的相对风险为0.5（95%置信区间 = 0.4 - 0.7）。在停止NSAID治疗1年后，风险降低完全消失。长期使用每日剂量为300mg阿司匹林的人群患结直肠癌的风险降低（相对风险 = 0.6；95%置信区间 = 0.4 - 0.9）。每日75mg和150mg阿司匹林剂量与结直肠癌风险降低无关。我们的数据支持非阿司匹林类NSAIDs持续摄入对结直肠癌具有重要保护作用这一观点，并指出每日至少300mg剂量的阿司匹林也有类似的风险降低作用。使用NSAIDs治疗1年可在1000名70 - 79岁的人群中预防1例结直肠癌。
Use of nonsteroidal antiinflammatory drugs (NSAIDs) has been associated with a reduced risk of colorectal cancer, but limited information is available on the effect of individual nonaspirin NSAIDs. In addition, the dose-response relation of aspirin in reducing the risk of colorectal cancer has not been described. We carried out a population-based cohort study with secondary case-control analysis to determine the association between the risk of colorectal cancer and use of aspirin and individual NSAIDs, including the role of dose and duration. The General Practice Research Database in the U.K. was the source population. We traced 943,903 persons 40-79 years of age and free of cancer and colorectal adenoma between January 1994 and September 1997. A total of 2,002 incident cases of colorectal cancer were ascertained. The incidence rate of colorectal cancer per 10,000 person-years was 7.3. The risk of colorectal cancer was reduced in users of nonaspirin NSAIDs and became evident after 6 months of continuous treatment. The adjusted relative risk was 0.5 (95% confidence interval = 0.4-0.7). The reduction in risk disappeared completely 1 after stopping NSAID treatment. The risk of developing colorectal cancer was reduced in long-term users of aspirin at doses of 300 mg daily (relative risk = 0.6; 95% confidence interval = 0.4-0.9). Daily doses of 75 and 150 mg aspirin were not associated with a reduced risk of colorectal cancer. Our data support the existence of an important protective effect of nonaspirin NSAID continuous intake against colorectal cancer and point to a similar reduction in risk for aspirin at doses of at least 300 mg daily. One-year treatment with NSAIDs would prevent one case of colorectal cancer in a population of 1,000 persons 70-79 years of age.