Aspirin, nonsteroidal anti-inflammatory drugs, paracetamol and risk of endometrial cancer: A case-control study, systematic review and meta-analysis
Aspirin, nonsteroidal anti-inflammatory drugs, paracetamol and risk of endometrial cancer: A case-control study, systematic review and meta-analysis
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DOI：
10.1002/ijc.27717
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发表时间：
2013-03-01
影响因子：
6.4
通讯作者：
Webb, Penelope M.
中科院分区：
文献类型：
--
作者：
Neill, Annette S.;Nagle, Christina M.;Webb, Penelope M.
阿司匹林和其他非甾体类抗炎药（NSAID）已与降低风险的一些癌症类型，然而，以前的研究子宫内膜癌已经产生了不确定的结果。我们分析了澳大利亚国家子宫内膜癌研究（ANECS）的数据，这是一项基于人群的病例对照研究（1，398例病例，740例对照）。我们系统地回顾了阿司匹林/NSAID使用与子宫内膜癌相关的所有证据，并进行了荟萃分析。对于ANECS，使用非条件logistic回归估计调整潜在混杂因素的比值比（OR）。对于系统性综述，我们检索了Pubmed、Embase、Web of Science，并对检索到的文章的引文进行了综述。使用随机效应模型汇总荟萃分析风险估计值。在我们的病例对照研究中，在过去5年中使用阿司匹林的女性患子宫内膜癌的风险显著降低，OR = 0.78 [95%置信区间（CI）：0.63-0.97]。有一个显着的反向剂量反应（p趋势= 2阿司匹林/周几乎一半的风险OR = 0.54（0.38-0.78）。未观察到半阿司匹林/天、非阿司匹林NSAID或扑热息痛的使用与子宫内膜癌风险之间存在显著相关性。当按癌症亚型检查时，结果相似。9项研究被纳入荟萃分析。使用阿司匹林与未使用阿司匹林的总体合并风险估计值为0.87（0.79-0.96），无异质性证据。肥胖女性（BMI >= 30 kg/m2）的合并风险估计值为0.72（0.58-0.90），但与非肥胖女性无关。总的来说，这些结果表明阿司匹林可以降低子宫内膜癌的风险，特别是在肥胖女性中。
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with reduced risk of a number of cancer types, however, previous studies of endometrial cancer have yielded inconclusive results. We analyzed data from the Australian National Endometrial Cancer Study (ANECS), a population-based case-control study (1,398 cases, 740 controls). We systematically reviewed all the evidence linking aspirin/NSAIDs use with endometrial cancer and conducted a meta-analysis. For ANECS, unconditional logistic regression was used to estimate odds ratios (OR) adjusting for potential confounders. For the systematic review, we searched Pubmed, Embase, Web of Science and conducted a review of citations from retrieved articles. The meta-analysis risk estimates were pooled using a random-effects model. In our case-control study, women who had ever used aspirin in the last 5 years had a significantly lower risk of endometrial cancer OR = 0.78 [95% confidence interval (CI): 0.63-0.97]. There was a significant inverse dose-response (p-trend = 2 aspirin/week had almost half the risk OR = 0.54 (0.38-0.78). No significant associations were observed between use of half-aspirin/day, non-aspirin NSAIDs or paracetamol and endometrial cancer risk. The results were similar when examined by cancer subtype. Nine studies were included in the meta-analysis. The overall pooled risk estimate for any versus no use of aspirin was 0.87 (0.79-0.96) with no evidence of heterogeneity. The pooled risk estimate for obese women (BMI >= 30 kg/m(2)) was 0.72 (0.58-0.90) but there was no association for non-obese women. Overall these results suggest that aspirin may reduce the risk of endometrial cancer, particularly among obese women.