Non-Steroidal Anti-Inflammatory Drug Use and Colorectal Polyps in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Non-Steroidal Anti-Inflammatory Drug Use and Colorectal Polyps in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
复制标题
DOI：
10.1038/ajg.2010.349
复制
发表时间：
2010-12-01
影响因子：
9.8
通讯作者：
Huang, Wen-Yi
中科院分区：
文献类型：
--
作者：
Johnson, Christine Cole;Hayes, Richard B.;Huang, Wen-Yi
目的：非甾体抗炎药（NSAIDs）在动物和人体研究中已被证明可降低结直肠癌和腺瘤性息肉的风险，但对人群亚组的风险调整和对增生性息肉的影响研究较少。最近使用两种经常摄入的NSAID（阿司匹林和布洛芬）的数据，在前列腺、肺癌、结直肠癌和卵巢癌筛查试验（PLCO）的10个中心的55-74岁的参与者中收集基线。随机分配到试验干预组的参与者在基线检查期间接受了乙状结肠镜检查。在试验环境外完成对检测到的息肉的随访，并寻找和提取相关记录。例（n = 4，017）包括活检证实左侧结肠息肉的受试者（降结肠、乙状结肠和直肠）作为PLCO筛查的结果检测;对照（n = 38，396）是没有左侧结肠息肉的受试者。经常服用阿司匹林（>= 4次/月）与增生性息肉呈负相关（比值比（OR）= 0.8，95%CI = 0.7-0.9）、腺瘤性息肉（OR = 0.8，95%CI = 0.8-0.9）和晚期腺瘤（OR = 0.8，95%CI = 0.7-0.9）。随着阿司匹林使用频率的增加，每种组织学分类的息肉患病率显著降低（趋势P = 2次/天），为0.6（95% CI = 0.5-0.8），而女性为0.9（95% CI = 0.8-1.1）。非甾体抗炎药对女性的保护作用仅在体重指数（BMI）较高的女性中明显
OBJECTIVES: Non-steroidal anti-inflammatory drugs (NSAIDs) have been documented in animal and human studies to reduce risk for colorectal cancer and adenomatous polyps, but risk modification for subgroups of the population and effects on hyperplastic polyps have been less studied.METHODS: Data on recent use of two frequently ingested NSAIDs, aspirin and ibuprofen, were collected at baseline from participants aged 55-74 years in the 10 centers of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Participants randomized to the intervention arm of the trial received a flexible sigmoidoscopy during a baseline examination. Follow-up of detected polyps was accomplished outside the Trial setting and relevant records were sought and abstracted. Cases (n = 4,017) included subjects with a biopsy-proven polyp in the left side of the colon (descending colon, sigmoid, and rectum) detected as a consequence of PLCO screening; controls (n = 38,396) were subjects with no left-sided colon polyp.RESULTS: Regular use of aspirin (>= 4 times/month) in the past year was inversely associated with hyperplastic polyps (odds ratios (OR) = 0.8, 95% confidence interval (CI) = 0.7-0.9), adenomatous polyps (OR = 0.8, 95% CI = 0.8-0.9), and advanced adenomas (OR = 0.8, 95% CI = 0.7-0.9). As frequency of aspirin use increased, the prevalence of polyps decreased significantly for each histological classification (P for trend = 2 times/day) was 0.6 (95% CI = 0.5-0.8), as opposed to 0.9 (95% CI = 0.8-1.1) in females. The protective effects of NSAIDs for females were apparent only among those with body mass index (BMI)