Use of Phosphodiesterase 5 Inhibitors Is Associated With Lower Risk of Colorectal Cancer in Men With Benign Colorectal Neoplasms
Use of Phosphodiesterase 5 Inhibitors Is Associated With Lower Risk of Colorectal Cancer in Men With Benign Colorectal Neoplasms
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DOI：
10.1053/j.gastro.2019.05.012
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发表时间：
2019-09-01
期刊：
影响因子：
29.4
通讯作者：
Ji, Jianguang
中科院分区：
文献类型：
--
作者：
Huang, Wuqing;Sundquist, Jan;Ji, Jianguang
背景与目的：磷酸二酯酶5 （PDE5）抑制剂已被提出对结直肠癌（CRC）具有化学预防作用，尽管需要基于人群的研究数据。我们进行了一项全国性的队列研究，以调查PDE5抑制剂的使用与男性良性结直肠癌风险之间的关系。方法：我们确定了2005年7月至2015年3月期间在瑞典医院出院登记簿中被诊断为良性结直肠肿瘤的男性。我们将数据与其他瑞典国家登记处的数据联系起来，以获得有关PDE5抑制剂处方和CRC诊断的信息。采用Cox回归计算风险比（hr）和95%置信区间（ci）。结果：在研究期间，共有4823名患者服用了PDE5抑制剂；服用PDE5抑制剂的男性CRC发病率为2.64 / 1000人年，而未服用PDE5抑制剂的男性CRC发病率为4.46 / 1000人年。我们发现PDE5抑制剂的使用与结直肠癌风险之间存在显著的负相关（校正HR， 0.65; 95% CI, 0.49-0.85）；结直肠癌风险的降低与PDE5抑制剂累积剂量的增加有关（P = 0.003）。PDE5处方与早期CRC（调整HR， 0.70; 95% CI, 0.50-0.98）相比，与晚期CRC（调整HR， 0.61; 95% CI, 0.37-1.00）的风险降低相关，但差异不显著。结论：在瑞典一项针对诊断为良性结直肠癌的男性的全国性人群研究中，我们发现了使用PDE5抑制剂与降低结直肠癌风险相关的证据。需要进一步的研究来证实观察到的关联。
BACKGROUND & AIMS: Phosphodiesterase 5 (PDE5) inhibitors have been proposed to have chemopreventative effects on colorectal cancer (CRC), although data are needed from population-based studies. We performed a nationwide cohort study to investigate the association between the use of PDE5 inhibitors and the risk of CRC in men with benign colorectal neoplasms. METHODS: We identified men who received a diagnosis of benign colorectal neoplasm from July 2005 through March 2015 who were listed in the Swedish Hospital Discharge Register. We linked data with those from other national Swedish registers to obtain information about the prescription of PDE5 inhibitors and CRC diagnoses. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: A total of 4823 patients were prescribed PDE5 inhibitors during the study period; the incidence rate of CRC was 2.64 per 1000 person-years for men prescribed PDE5 inhibitors compared with 4.46 per 1000 person-years for men without a prescription. We found a significant negative association between PDE5 inhibitor use and risk of CRC (adjusted HR, 0.65; 95% CI, 0.49-0.85); the decreased risk of CRC was associated with an increased cumulative dose of PDE5 inhibitors (P = .003). PDE5 prescription was associated with greater reduction in risk of advanced-stage CRC (adjusted HR, 0.61; 95% CI, 0.37-1.00) than early-stage CRC (adjusted HR, 0.70; 95% CI, 0.50-0.98), but the difference was not significant. CONCLUSIONS: In a nationwide population-based study of men with a diagnosis of benign colorectal neoplasm in Sweden, we found evidence that use of PDE5 inhibitors is associated with a reduced risk of CRC. Further studies are needed to confirm the observed association.