A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence
A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence
复制标题
DOI：
10.1093/jnci/djk132
复制
发表时间：
2007-04-18
影响因子：
10.3
通讯作者：
Calle, Eugenia E.
中科院分区：
文献类型：
--
作者：
Jacobs, Eric J.;Thun, Michael J.;Calle, Eugenia E.
流行病学证据表明，阿司匹林的使用与结肠癌和可能的其他几种癌症（包括前列腺癌和乳腺癌）的风险降低有关。最近的妇女健康研究随机试验结果表明，长期使用低剂量阿司匹林（每隔一天100毫克）并不能显著降低癌症风险。然而，长期每日使用高剂量阿司匹林对癌症发病率的潜在影响仍然不确定。（>= 325 mg/天）以及参与癌症预防研究II营养队列的69810名男性和76303名女性的总体癌症发病率和10种癌症的发病率，人口相对老龄化。阿司匹林的使用在1992 - 1993年入组时报告，并在1997年、1999年和2001年更新。多变量考克斯比例风险回归被用来计算率ratios（RRs）。结果在随访至2003年6月，10931名男性和7196名女性被诊断为癌症。长期与不使用阿司匹林相比，每天使用成人剂量阿司匹林（>= 5年）的男性总体癌症发病率较低（多变量校正RR = 0.84，95%置信区间中心点[Cl]= 0.76至0.93），女性总体癌症发病率无统计学显著性降低（多变量调整的RR = 0.86，95% CI = 0.73至1.03）。长期每日服用阿司匹林和不服用阿司匹林的男性和女性的癌症发病率分别为1858和2163/10万人-年，女性分别为1083和1169/10万人-年（标准化为研究中男性和女性的年龄分布）。长期每日服用阿司匹林与结直肠癌发病率降低有关（男性和女性合并的RR = 0.68，95% CI = 0.52至0.90）和前列腺癌（RR 0.81，95% CI = 0.70至0.94），女性乳腺癌风险无统计学显著性降低结论长期每日使用成人剂量阿司匹林可能与总体癌症发病率的适度降低有关，其中结直肠癌、前列腺癌和乳腺癌是常见的。
Background Epidemiologic evidence indicates that aspirin use is associated with reduced risks of colon cancer and possibly several other cancers, including prostate and breast cancers. Recent results from the Women's Health Study randomized trial indicate that long-term use of low-dose aspirin (100 mg every other day) does not substantially reduce cancer risk. However, the potential effect of long-term daily use of higher doses of aspirin on cancer incidence remains uncertain.Methods We examined associations between long-term daily use of adult-strength aspirin (>= 325 mg/day) and both overall cancer incidence and incidence of 10 types of cancer among 69810 men and 76303 women participating in the Cancer Prevention Study II Nutrition Cohort, a relatively elderly population. Aspirin use was reported at enrollment in 1992-1993 and updated in 1997, 1999, and 2001. Multivariable Cox proportional hazards regression was used to calculate rate ratios (RRs).Results During follow-up through June 2003, 10931 men and 7196 women were diagnosed with cancer. Longterm (>= 5 years) daily use of adult-strength aspirin, compared with no use, was associated with lower overall cancer incidence in men (multivariable-adjusted RR = 0.84, 95% confidence interval center dot[Cl] = 0.76 to 0.93) and non-statistically significantly lower overall cancer incidence in women (multivariable-adjusted RR = 0.86, 95% Cl = 0.73 to 1.03). Overall cancer incidence per 100000 person-years (standardized to the age distributions of men and women in the study) with long-term daily aspirin use and no aspirin use was 1858 and 2163, respectively, among men and 1083 and 1169, respectively, among women. Long-term daily aspirin use was associated with lower incidence of colorectal cancer (RR = 0.68, 95% Cl = 0.52 to 0.90 among men and women combined) and prostate cancer (RR 0.81, 95% Cl = 0.70 to 0.94) and a non-statistically significant lower risk of female breast cancer (RR 0.83, 95% Cl = 0.63 to 1.10).Conclusions Long-term daily use of adult-strength aspirin may be associated with modestly reduced overall cancer incidence in populations among whom colorectal, prostate, and breast cancers are common.