Non-steroidal anti-inflammatory drugs and colorectal cancer risk in a large, prospective cohort.
Non-steroidal anti-inflammatory drugs and colorectal cancer risk in a large, prospective cohort.
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DOI：
10.1038/ajg.2011.38
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发表时间：
2011-07
影响因子：
9.8
通讯作者：
Cross, Amanda J.
中科院分区：
文献类型：
--
作者：
Ruder, Elizabeth H.;Laiyemo, Adeyinka O.;Graubard, Barry I.;Hollenbeck, Albert R.;Schatzkin, Arthur;Cross, Amanda J.
非甾体抗炎药（NSAIDs）的使用与结直肠癌呈负相关；然而，在结直肠亚部位内或高危人群中的相关性研究不足。我们在美国国立卫生研究院 - 美国退休人员协会饮食与健康研究中，按亚部位以及在有结肠癌家族史的个体中调查了非甾体抗炎药的使用与结直肠腺癌的关系。
使用考克斯比例风险回归，我们估计了301240名男性和女性（平均年龄62.8岁）中结直肠癌发病的风险比（HR）和95%置信区间（CI），其中包括26994名有一级亲属有结肠癌病史的个体。在10年的随访中，我们累计发现3894例结直肠癌病例，其中372例有一级亲属患结肠癌。
阿司匹林和非阿司匹林类非甾体抗炎药的使用都降低了结直肠癌的风险（使用者与非使用者相比，HR = 0.91，95% CI：0.85，0.98；HR = 0.82，95% CI：0.77，0.87）。每日使用阿司匹林降低了远端结肠（HR = 0.84，95% CI：0.71，0.99）和直肠（HR = 0.76，95% CI：0.64，0.90）患癌的风险；每日使用非阿司匹林类非甾体抗炎药降低了近端（HR = 0.65，95% CI：0.54，0.78）和远端结肠癌（HR = 0.69，95% CI：0.55，0.87）的风险，但不降低直肠癌的风险。在有一级亲属患结肠癌的参与者中，每日使用阿司匹林与直肠癌风险降低相关（HR = 0.38，95% CI：0.19，0.78），每日使用非阿司匹林类非甾体抗炎药与结肠癌风险降低相关（HR = 0.49，95% CI：0.29，0.82）。在这个高危亚组中，未观察到每日使用阿司匹林对结肠癌或每日使用非阿司匹林类非甾体抗炎药对直肠癌有保护作用，尽管由于病例数少，统计效力有限。
非甾体抗炎药的使用与结直肠癌风险降低相关；阿司匹林和非阿司匹林类非甾体抗炎药之间这种相关性的程度不同。有结肠癌家族史的个体每日使用阿司匹林和非阿司匹林类非甾体抗炎药分别显著降低了直肠和结肠癌的风险。
Use of non-steroidal anti-inflammatory drugs (NSAIDs) has been inversely associated with colorectal cancer; however, the association within colorectal subsites or among higher risk individuals is understudied. We investigated NSAID use and colorectal adenocarcinoma by subsite, and among individuals with a family history of colon cancer in the National Institutes of Health-AARP Diet and Health Study. Using Cox proportional hazards regression, we estimated hazard ratios (HR) and 95% confidence intervals (CI) for colorectal cancer incidence among 301,240 men and women (mean age 62.8 y); including 26,994 individuals with a first degree relative with a history of colon cancer. We accrued 3,894 colorectal cancer cases during 10 years of follow-up; 372 cases had a first degree relative with colon cancer. Both aspirin and non-aspirin NSAID use reduced colorectal cancer risk (HR for users compared to non-users=0.91, 95% CI: 0.85, 0.98; HR=0.82, 95% CI: 0.77, 0.87, respectively). Daily aspirin use reduced the risk of cancer in the distal colon (HR=0.84, 95% CI: 0.71, 0.99) and rectum (HR=0.76, 95% CI: 0.64, 0.90); daily non-aspirin NSAID use reduced the risk of both proximal (HR=0.65, 95% CI: 0.54, 0.78) and distal colon cancer (HR=0.69, 95% CI: 0.55, 0.87), but not rectal cancer. Among participants with a first degree relative with colon cancer, daily use of aspirin was associated with a decreased risk of rectal cancer (HR= 0.38, 95% CI: 0.19, 0.78), and daily use of non-aspirin NSAIDs was associated with a decreased risk of colon cancer (HR= 0.49, 95% CI: 0.29, 0.82). No protective benefit for daily aspirin use and colon cancer or daily non-aspirin NSAID use and rectal cancer was observed in this higher risk subgroup, although power was limited by small case numbers. NSAID use was associated with a reduced colorectal cancer risk; the magnitude of this association differed between aspirin and non-aspirin NSAIDs. Daily aspirin and non-aspirin NSAID use by individuals with a family history of colon cancer significantly reduced the risk of rectal and colon cancer, respectively.
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影响因子：
158.5
作者：
GIOVANNUCCI, E;EGAN, KM;SPEIZER, FE
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SPEIZER, FE
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120.7
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作者：
Mahipal, Amit;Anderson, Kristin E.;Folsom, Aaron R.
通讯作者：
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