5-Aminosalicylate Is Not Chemoprophylactic for Colorectal Cancer in IBD: A Population Based Study
5-Aminosalicylate Is Not Chemoprophylactic for Colorectal Cancer in IBD: A Population Based Study
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DOI：
10.1038/ajg.2011.50
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发表时间：
2011-04-01
影响因子：
9.8
通讯作者：
Blanchard, James F.
中科院分区：
文献类型：
--
作者：
Bernstein, Charles N.;Nugent, Zoann;Blanchard, James F.
目的：我们旨在确定5-氨基水杨酸盐（5-ASA）的使用是否与炎症性肠病（IBD）患者结直肠癌（CRC）风险降低相关。方法：我们使用以人群为基础的马尼托巴大学IBD流行病学数据库，该数据库跟踪了1984年至2008年马尼托巴所有IBD患者的所有医疗保健访问和1995年以来的所有处方药使用情况。2008年，有8,744例IBD患者（溃疡性结肠炎4,325例，克罗恩病4,419例，女性4,851例，男性3,893例）。在研究I中，我们评估了5- asa使用者（>= 1年，>= 5年累积使用）与非使用者的CRC发病率。在研究II中，我们评估了1995-2008年诊断为CRC的队列（n = 101），根据年龄、性别、病程和未诊断为CRC的疾病诊断（n = 303）与对照队列相匹配，并进行了logistic分析。结果：在研究1中，使用>= 1年时，5- asa使用者发生结直肠癌的风险比为1.04(95%可信区间（CI） 0.67-1.62, P = 0.87)，使用>= 5年时的风险比为2.01 (95% CI 1.04-3.9, P = 0.038)，诊断评估无差异。使用5- asa达bb0 = 5年的男性患CRC的风险增加，而非女性。在研究II中，与对照组相比，结直肠癌患者在>= 1年（1.02,95% CI 0.60-1.74）或>= 5年（1.96,95% CI 0.84-4.55）的5- asa使用情况相似，5- asa处方的平均数量相似，为10比11 (P = 0.8)，平均剂量天数相似，为330比410 （P = 0.69）。结论：我们的结果支持大多数迄今为止的研究，即5-ASA对结直肠癌的IBD没有化学预防作用。
OBJECTIVES: We aimed to determine if use of 5-aminosalicylates (5-ASA) was associated with a reduced risk of colorectal cancer (CRC) in people with inflammatory bowel disease (IBD).METHODS: We used the population-based University of Manitoba IBD Epidemiology Database that tracks all health-care visits from 1984 to 2008 of all Manitobans with IBD and all prescription medication use since 1995. In 2008, there were 8,744 subjects with IBD (ulcerative colitis 4,325, Crohn's disease 4,419, females 4,851, males 3,893). In study I, we assessed the incidence of CRC among 5-ASA users (>= 1 year, >= 5 years of cumulative use) compared with nonusers. In study II, we assessed a cohort of those with CRC (n = 101) diagnosed in 1995-2008, matched to a control cohort by age, sex, disease duration, and disease diagnosis without CRC (n = 303), and logistic analysis was undertaken.RESULTS: For study I, the hazard ratio for CRC among 5-ASA users was 1.04 (95% confidence interval (CI) 0.67-1.62, P = 0.87) at >= 1 year of use and 2.01 (95 % CI 1.04-3.9, P = 0.038) at >= 5 years of use with no difference when assessing by diagnosis. Males, but not females, using 5-ASA for >= 5 years had an increased risk of CRC. In study II, CRC cases had similar use of any 5-ASA compared with controls for >= 1 year of use (1.02, 95 % CI 0.60-1.74) or >= 5 years (1.96, 95 % CI 0.84-4.55), and a similar mean number of 5-ASA prescriptions at 10 vs. 11 (P = 0.8) and a similar mean number of dose days at 330 vs. 410 (P = 0.69).CONCLUSIONS: Our results support the majority of studies to date that 5-ASA is not chemoprophylactic in IBD for CRC.