Secular changes in NSAID use and invasive colorectal cancer incidence: an ecological study.
Secular changes in NSAID use and invasive colorectal cancer incidence: an ecological study.
复制标题
非甾体抗炎药使用和侵袭性结直肠癌发病率的长期变化：一项生态研究。
DOI：
10.1097/ppo.0b013e318182ee67
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Dias,LaurenE
中科院分区：
文献类型：
--
作者：
Lamont,ElizabethB;Dias,LaurenE
BackgroundThe National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program has documented large secular changes in incidence of invasive colorectal cancer (CRC) between 1973 through the present day. Researchers have suggested several reasons for these changes including changes in CRC screening over this period 1–5 and increases in use, by the population, of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDS have been shown in both observational studies and randomized control trials to prevent precancerous colorectal polyps and subsequent invasive CRC. 6–14ObjectivesIn this exploratory ecological project, we sought to describe trends in NSAID use over time and trends in CRC incidence over time to inform the plausibility of the hypothesis that secular decreases in CRC incidence observed over the last 20 years are causally related to secular increases in NSAID use by the population. We hypothesized that an increase in NSAID use by the population would need to precede any fall in CRC incidence by 6 to 10 years to be consistent with an NSAID mediated risk reduction as this was the induction period Chan et al found in their cohort studies of NSAID and/or aspirin use and subsequent CRC diagnoses. 15, 16METHODSWe used publicly available data from the National Center for Health Statistics’(NCHS) National Ambulatory Medical Care Survey (NAMCS) to estimate NSAID use over time. 17 The NAMCS is an annual national sample survey of visits to office-based physicians that is designed to collect objective, reliable information about the provision, and use of ambulatory medical care services in the United States. It uses a multistage probability design with the physician–patient office visit as the basic sampling unit. The information collected includes patient demographics, as well as information regarding patients’ medical diagnoses and current medications, both over-the-counter and prescription.
