Aspirin Use and Reduced Risk of Pancreatic Cancer.
Aspirin Use and Reduced Risk of Pancreatic Cancer.
复制标题
DOI：
10.1158/1055-9965.epi-16-0508
复制
发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Gao YT
中科院分区：
文献类型：
--
作者：
Risch HA;Lu L;Streicher SA;Wang J;Zhang W;Ni Q;Kidd MS;Yu H;Gao YT
除了避免吸烟和肥胖之外，很少有其他选择可以预防胰腺癌。阿司匹林使用与胰腺癌风险之间的关联在各项研究中并不一致。我们对 2006 年至 2011 年中国上海的 761 名病例和 794 名对照受试者进行了一项基于人口的研究，这些受试者的性别和年龄频率匹配。参与者被问及每天或每周定期服用阿司匹林、药片的情况，以及开始和停止使用的年龄。通过无条件逻辑回归分析数据，并调整年龄、性别、教育程度、体重指数、吸烟年限、每天吸烟支数、幽门螺杆菌 CagA 血清阳性、ABO 血型和糖尿病史。进行元回归来总结文献。经常服用阿司匹林与降低胰腺癌风险相关：比值比 [OR] = 0.54； 95% CI，0.40–0.73，P=10−4.2。每累积使用一年，风险降低 8%：ORtrend = 0.92； 95% CI，0.87–0.97； P=.0034。在这项研究以及已发表的 18 项相关研究中，对于任何阿司匹林类型 (Ptrend=10−5.1) 和低剂量阿司匹林 (Ptrend=0.0014)，经常使用的 OR 随着研究年中期的增加而降低。因此，经常服用阿司匹林似乎可以将胰腺癌的风险降低近一半。服用阿司匹林预防其他疾病的人也可能降低患胰腺癌的风险。除了对心血管疾病和某些癌症有益之外，长期使用阿司匹林还会带来一些出血并发症的风险，因此需要对个人使用阿司匹林的决定进行风险效益分析。
Few options beside avoidance of smoking and obesity are available to prevent pancreatic cancer. The association between aspirin use and risk of pancreatic cancer has been inconsistent across studies. We performed a population-based study of 761 case and 794 control subjects frequency matched on sex and age during 2006–2011 in Shanghai, China. Participants were asked about episodes of regular use of aspirin, tablets per day or week, and ages that use started and stopped. Data were analyzed by unconditional logistic regression, with adjustments for age, sex, education, body-mass index, years of cigarette smoking, cigarettes smoked per day, Helicobacter pylori CagA seropositivity, ABO blood group, and history of diabetes mellitus. Meta-regression was carried out to summarize the literature. Ever-regular use of aspirin was associated with lowered risk of pancreatic cancer: odds ratio [OR] = 0.54; 95% CI, 0.40–0.73, P=10−4.2. Risk decreased 8% per each cumulative year of use: ORtrend = 0.92; 95% CI, 0.87–0.97; P=.0034. Across this and 18 published studies of this association, the OR for ever-regular use decreased with increasingly more recent mid-study year, for any aspirin type (Ptrend=10−5.1), and for low-dose aspirin (Ptrend=0.0014). Regular use of aspirin thus appears to reduce risk of pancreatic cancer by almost half. People who take aspirin for prevention of other diseases likely also reduce their risk of pancreatic cancer. Aside from benefits for both cardiovascular disease and certain cancers, long-term aspirin use entails some risks of bleeding complications which necessitates risk-benefit analysis for individual decisions about use.