EFFECT OF ASPIRIN AND NONSTEROIDAL ANTIINFLAMMATORY DRUGS ON COLORECTAL ADENOMAS - CASE-CONTROL STUDY OF SUBJECTS PARTICIPATING IN THE NOTTINGHAM FECAL OCCULT BLOOD SCREENING-PROGRAM
EFFECT OF ASPIRIN AND NONSTEROIDAL ANTIINFLAMMATORY DRUGS ON COLORECTAL ADENOMAS - CASE-CONTROL STUDY OF SUBJECTS PARTICIPATING IN THE NOTTINGHAM FECAL OCCULT BLOOD SCREENING-PROGRAM
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DOI：
10.1136/bmj.307.6899.285
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发表时间：
1993-07-31
影响因子：
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通讯作者：
HARDCASTLE, JD
中科院分区：
文献类型：
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作者：
LOGAN, RFA;LITTLE, J;HARDCASTLE, JD
目的-探讨阿司匹林和非甾体类抗炎药的使用与无症状结直肠腺瘤的存在之间的关系。对参与结直肠癌粪便潜血筛查随机对照试验的受试者进行设计病例对照研究。镇痛药和其他药物的数据来自主要与饮食有关的调查问卷，并由采访者进行。设置-诺丁汉。受试者-147名粪便潜血测试呈阳性但发现患有结直肠腺瘤的患者（病例），153名年龄和性别匹配的测试结果呈阴性的对照受试者（阴性对照），以及176名测试结果呈阳性但未发现结直肠腺瘤的对照受试者腺瘤（阳性对照）。主要结果指标 - 根据镇痛药的使用频率和持续时间，发生结直肠腺瘤的相对风险。结果 - 病例报告服用的阿司匹林和非甾体抗炎药少于阴性对照，任何使用的估计相对风险为 0.49（95% 置信区间 0.3 至 0.8）。当病例与阳性对照相比时，负相关性不太强（0.66（0.4 至 1.1））。这种关联是阿司匹林和非甾体类抗炎药所特有的，与扑热息痛或其他药物没有关联。尽管报告长期使用非甾体抗炎药的人数很少，但服用非甾体抗炎药超过五年的风险最低（0.21（0.1至0.8））。 结论 - 这些发现支持阿司匹林和非甾体抗炎药的使用可预防结直肠肿瘤发展的假设。
Objective-To examine the relation between the use of aspirin and non-steroidal anti-inflammatory drugs and the presence of asymptomatic colorectal adenomas.Design-Case-control study of subjects participating in a randomised controlled trial of faecal occult blood screening for colorectal cancer. Data on analgesics and other drugs were obtained from a questionnaire which was mainly concerned with diet and was administered by an interviewer.Setting-Nottingham.Subjects-147 patients with positive results in faecal occult blood tests who were found to have colorectal adenomas (cases), 153 age and sex matched control subjects with negative results in such tests (negative controls), and 176 control subjects with positive results in the tests who were found not to have colorectal adenomas (positive controls).Main outcome measures-Relative risk of developing colorectal adenomas according to frequency and duration of use of analgesics.Results-Cases reported taking less aspirin and non-steroidal anti-inflammatory drugs than the negative controls, with the estimated relative risk for any use being 0.49 (95% confidence interval 0.3 to 0.8). The inverse association was less strong when cases were compared with the positive controls (0.66 (0.4 to 1.1)). The association was specific for aspirin and non-steroidal anti-inflammatory drugs there being no association with paracetamol or other drugs. Prescribed use of non-steroidal anti-inflammatory drugs for longer than five years was associated with the lowest risk (0.21 (0.1 to 0.8)), although the numbers reporting prolonged prescribed use were small.Conclusions-These findings support the hypothesis that aspirin and non-steroidal anti-inflammatory drug use protects against the development of colorectal neoplasia.