Use of Bisphosphonates and Reduced Risk of Colorectal Cancer
Use of Bisphosphonates and Reduced Risk of Colorectal Cancer
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DOI：
10.1200/jco.2010.33.7485
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发表时间：
2011-03-20
影响因子：
45.3
通讯作者：
Gruber, Stephen B.
中科院分区：
文献类型：
--
作者：
Rennert, Gad;Pinchev, Mila;Gruber, Stephen B.
目的双磷酸盐通常用于治疗乳腺癌引起的骨质疏松症和骨转移，最近有报道称其与降低乳腺癌风险相关，可能通过甲羟戊酸途径发挥作用，但其与其他癌症风险的相关性尚不清楚。 患者和方法结直肠癌分子流行病学研究是一项在以色列北部针对结直肠癌患者进行的基于人群的病例对照研究 癌症和年龄、性别、临床和种族群体匹配的对照。使用计算机化药房记录，对 933 对参加 Clalit 健康服务的绝经后女性患者和对照者在诊断前长期使用双膦酸盐进行了评估。结果诊断前使用双膦酸盐超过 1 年，但不少于 1 年，与结直肠癌相对风险 (RR) 显着降低相关（RR，0.50；95% CI， 0.35 至 0.71）。在对蔬菜消费、体育活动、结直肠癌家族史、体重指数以及低剂量阿司匹林、他汀类药物、维生素 D 和绝经后激素的使用模型进行调整后，这种关联仍然具有统计学意义（RR，0.41；95% CI，0.25 至 0.67）。同时使用双膦酸盐和他汀类药物并没有进一步降低风险。 结论 口服双膦酸盐使用 1 年以上与结直肠癌风险相对降低 59% 相关，类似于最近报道的此类药物与乳腺癌风险降低的相关性。 J 临床肿瘤杂志 29：1146-1150。 (C) 2011 年美国临床肿瘤学会
PurposeBisphosphonates are commonly used for the treatment of osteoporosis and bone metastases caused by breast cancer and were recently reported to be associated with a reduced risk of breast cancer, possibly acting through the mevalonate pathway, but their association with risk of other cancers is unknown.Patients and MethodsThe Molecular Epidemiology of Colorectal Cancer study is a population-based, case-control study in northern Israel of patients with colorectal cancer and age-, sex-, clinic-, and ethnic group-matched controls. Long-term use of bisphosphonates before diagnosis was assessed in a subset of 933 pairs of postmenopausal female patients and controls, enrolled in Clalit Health Services, using computerized pharmacy records.ResultsThe use of bisphosphonates for more than 1 year before diagnosis, but not for less than 1 year, was associated with a significantly reduced relative risk (RR) of colorectal cancer (RR, 0.50; 95% CI, 0.35 to 0.71). This association remained statistically significant after adjustment in a model for vegetable consumption, sports activity, family history of colorectal cancer, body mass index, and use of low-dose aspirin, statins, vitamin D, and postmenopausal hormones (RR, 0.41; 95% CI, 0.25 to 0.67). Concomitant use of bisphosphonates and statins did not further reduce the risk.ConclusionThe use of oral bisphosphonates for more than 1 year was associated with a 59% relative reduction in the risk of colorectal cancer, similar to the recently reported association of this drug class with reduction in breast cancer risk. J Clin Oncol 29:1146-1150. (C) 2011 by American Society of Clinical Oncology