Exposure to bisphosphonates and risk of colorectal cancer
Exposure to bisphosphonates and risk of colorectal cancer
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DOI：
10.1002/cncr.26395
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发表时间：
2012-03-01
期刊：
影响因子：
6.2
通讯作者：
Bernstein, Charles
中科院分区：
文献类型：
--
作者：
Singh, Harminder;Nugent, Zoann;Bernstein, Charles
背景：化学预防是减少结直肠癌（CRC）负担的一种潜在的有吸引力的策略。临床前研究表明，双膦酸盐（bp）可能对结直肠癌有直接的抗肿瘤作用。本研究的目的是确定bp暴露对CRC发病率的影响。方法：使用曼尼托巴癌症登记处识别2000年至2009年诊断为结直肠癌的患者，这些患者在诊断前至少在曼尼托巴居住了5年（例）。每个病例与10个年龄、性别和在曼尼托巴居住时间相似的对照组相匹配，采用发病率密度抽样。使用省级药物计划信息网络数据库确定bp暴露情况。通过条件logistic回归分析，确定bp暴露对CRC发病率的影响，并对医疗保健使用、医疗程序（包括下消化道内窥镜检查）、社会经济地位和既往健康状况进行调整。结果：总共有5425例结直肠癌患者与54242例对照组相匹配。在多变量分析中，BP暴露与CRC风险降低相关（>= 5年内2-13 BP处方：优势比[OR] 0.84； 95%可信区间[CI]，0.71-1.00; >= 14 BP处方，>= 5年：OR， 0.78; 95% CI, 0.65-0.94）。当评估特定降压剂的作用时，只有暴露于利塞膦酸时效果显著（OR, 0.50; 95% CI, 0.30-0.85）。增加阿仑膦酸的持续时间或累积剂量均无显著影响。结论：本研究的结果表明，暴露于bp，特别是利塞膦酸，可能与发生结直肠癌的风险降低有关。癌症2012;118: 1236 - 43。(C) 2011年美国癌症协会。
BACKGROUND: Chemoprevention is a potentially attractive strategy for decreasing the burden of colorectal cancer (CRC). Preclinical studies suggest that bisphosphonates (BPs) may have direct antitumour effects against CRC. The objective of this study was to determine the effect of exposure to BPs on the incidence of CRC. METHODS: The Manitoba Cancer Registry was used to identify patients who were diagnosed withCRC from 2000 to 2009 who had been living in Manitoba for at least 5 years before diagnosis (cases). Each case was matched to 10 controls of similar age, sex, and duration of residence in Manitoba using incidence density sampling. Exposure to BPs was determined using the provincial Drug Program Information Network database. Conditional logistic regression analysis was performed to determine the effect of exposure to BPs on CRC incidence with adjustment for health care use, medical procedures (including lower gastrointestinal endoscopy), socioeconomic status, and pre-existing health conditions. RESULTS: In total, 5425 patients with CRC were matched to 54,242 controls. In the multivariate analysis, exposure to BPs was associated with a reduction in the risk of CRC (2-13 BP prescriptions over >= 5 years: odds ratio [OR] 0.84; 95% confidence interval [CI],0.71-1.00; >= 14 BP prescriptions over >= 5 years: OR, 0.78; 95% CI, 0.65-0.94). When the effect of specific BP agents was evaluated, the effect was significant only for exposure to risedronic acid (OR, 0.50; 95% CI, 0.30-0.85). There was no significant effect of increasing duration or cumulative dose of alendronic acid. CONCLUSIONS: The results from this study suggested that exposure to BPs, especially risedronic acid, may be associated with a decreased risk of developing CRC. Cancer 2012; 118: 1236-43. (C) 2011 American Cancer Society.