Effect of Aspirin on Cancer Chemoprevention in Japanese Patients With Type 2 Diabetes: 10-Year Observational Follow-up of a Randomized Controlled Trial
Effect of Aspirin on Cancer Chemoprevention in Japanese Patients With Type 2 Diabetes: 10-Year Observational Follow-up of a Randomized Controlled Trial
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DOI：
10.2337/dc18-0368
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发表时间：
2018-08-01
期刊：
影响因子：
16.2
通讯作者：
Saito, Yoshihiko
中科院分区：
文献类型：
--
作者：
Okada, Sadanori;Morimoto, Takeshi;Saito, Yoshihiko
CAPTIVEThis study analyzed the efficacy of low-dose aspirin in cancer chemoprevention in patients with diabetes.RESEARCH DESIGN AND METHODS本研究是一项试验后随访的日本一级预防动脉粥样硬化与阿司匹林糖尿病（JPAD）试验。JPAD试验的参与者（2，536名日本2型糖尿病患者，无既往心血管疾病）被随机分配接受阿司匹林（每天81或100 mg）或不接受阿司匹林。在2008年试验结束后，我们对参与者进行了随访，直到2015年，没有试图改变之前分配的治疗。主要终点是总癌症发病率。我们调查了低剂量阿司匹林对癌症发病率的影响。在中位随访期10.7年期间，共有318例癌症发生。阿司匹林组和无阿司匹林组之间的癌症发病率无显著差异（对数秩，P = 0.4;风险比[HR]，0.92; 95% CI，0.73-1.14; P = 0.4）。在亚组分析中，阿司匹林不影响男性、女性或65岁参与者的癌症发病率。然而，它降低了年龄较大的参与者的癌症发病率。
OBJECTIVEThis study analyzed the efficacy of low-dose aspirin in cancer chemoprevention in patients with diabetes.RESEARCH DESIGN AND METHODSThis study was a posttrial follow-up of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial. Participants in the JPAD trial (2,536 Japanese patients with type 2 diabetes and without preexisting cardiovascular disease) were randomly allocated to receive aspirin (81 or 100 mg daily) or no aspirin. After that trial ended in 2008, we followed up with the participants until 2015, with no attempt to change the previously assigned therapy. The primary end point was total cancer incidence. We investigated the effect of low-dose aspirin on cancer incidence.RESULTSDuring the median follow-up period of 10.7 years, a total of 318 cancers occurred. The cancer incidence was not significantly different between the aspirin and no-aspirin groups (log-rank, P = 0.4; hazard ratio [HR], 0.92; 95% CI, 0.73-1.14; P = 0.4). In subgroup analyses, aspirin did not affect cancer incidence in men, women, or participants aged 65 years. However, it decreased cancer incidence in participants aged