Aspirin use and survival after the diagnosis of breast cancer: a population-based cohort study.
Aspirin use and survival after the diagnosis of breast cancer: a population-based cohort study.
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DOI：
10.1038/bjc.2014.264
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发表时间：
2014-07-29
影响因子：
8.8
通讯作者：
McCowan, C.
中科院分区：
文献类型：
--
作者：
Fraser, D. M.;Sullivan, F. M.;Thompson, A. M.;McCowan, C.
阿司匹林的使用与癌症发病率的降低和癌症死亡的减少有关。这项研究调查了乳腺癌患者在确诊后服用阿司匹林是否提高了生存率。一项观察性的人群队列研究利用苏格兰泰赛德癌症登记、处方处方和死亡记录的数据联系进行。所有乳腺癌女性患者服用阿司匹林的社区处方都被提取出来，并使用COX比例风险模型对每个个体进行诊断后检查。主要的结果指标是全因死亡率和乳腺癌特异性死亡率。对1998年1月1日至2008年12月31日期间被诊断为乳腺癌的4,627名患者进行了跟踪调查，直至2010年2月28日。确诊时的中位年龄为62岁(IQR 52-74)。有记录的死亡人数为1,802人(39%)，其中815人(18%)死于乳腺癌。1,035例(22%)患者在诊断后服用阿司匹林。在调整了年龄、社会经济状况、肿瘤分期、肿瘤分级、雌激素受体状态、手术、放疗、化疗、辅助内分泌治疗和使用阿司匹林后，使用阿司匹林的患者全因死亡率(HR=0.53，95%CI=0.45-0.63，P<；0.001)和乳腺癌相关死亡率(HR=0.42，95%CI=0.31-0.55，P<；0.001)显著降低。乳腺癌确诊后使用阿司匹林可能会降低全因死亡率和乳腺癌特异性死亡率。寻求因果关系的进一步研究以及哪些患者亚组受益最多，有待正在进行的随机对照试验。
Aspirin use has been associated with a reduced cancer incidence and fewer deaths from cancer. This study examined whether women with breast cancer prescribed aspirin postdiagnosis had improved survival. An observational, population cohort study was undertaken using data linkage of cancer registry, dispensed prescriptions and death records in Tayside, Scotland. All community prescriptions for aspirin in women with breast cancer were extracted and use postdiagnosis for each individual examined using Cox's proportional hazard models. The main outcome measures were all-cause mortality and breast cancer-specific mortality. Four thousand six hundred and twenty-seven patients diagnosed with breast cancer between 1 January 1998 and 31 December 2008 were followed up until 28 February 2010. Median age at diagnosis was 62 (IQR 52–74). One thousand eight hundred and two (39%) deaths were recorded, with 815 (18%) attributed to breast cancer. One thousand and thirty-five (22%) patients were prescribed aspirin postdiagnosis. Such aspirin use was associated with lower risk of all-cause mortality (HR=0.53, 95% CI=0.45–0.63, P<0.001) and breast cancer-specific mortality (HR=0.42, 95% CI=0.31–0.55, P<0.001) after adjusting for age, socioeconomic status, TNM stage, tumour grade, oestrogen receptor status, surgery, radiotherapy, chemotherapy, adjuvant endocrine therapy and aspirin use prediagnosis. Aspirin use postdiagnosis of breast cancer may reduce both all-cause and breast cancer-specific mortality. Further investigation seeking a causal relationship and which subgroups of patients benefit most await ongoing randomised controlled trials.
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影响因子：
10.3
作者：
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通讯作者：
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作者：
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