Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies.
Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies.
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DOI：
10.1002/ijc.28093
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发表时间：
2014-01-15
影响因子：
6.4
通讯作者：
Cho, Eunyoung
中科院分区：
文献类型：
--
作者：
Choueiri, Toni K.;Je, Youjin;Cho, Eunyoung
止痛药是世界上最常用的非处方药，某些止痛药具有预防癌症的作用。使用止痛剂会增加患肾癌的风险，这一证据喜忧参半。我们使用现有的观察性流行病学研究的荟萃分析设计，调查了镇痛药使用与肾癌风险之间的关系。我们检索了MEDLINE和EMBASE数据库，以确定截至2012年6月发表的3类镇痛药的合格病例对照或队列研究：对乙酰氨基酚、阿司匹林或其他非甾体抗炎药（NSAID）。合并研究特定效应估计值，使用随机效应模型计算各类镇痛药的总体相对风险（RR）及其95%置信区间（CI）。我们确定了在6个国家进行的20项研究（14项使用对乙酰氨基酚，13项使用阿司匹林，5项使用其他NSAID），包括8，420例肾癌病例。使用对乙酰氨基酚和非阿司匹林NSAID与肾癌风险增加相关（合并RR，1.28; 95% CI，分别为1.15 - 1.44和1.25; 95% CI，1.06 - 1.46）。对于阿司匹林的使用，我们没有发现总体风险增加（汇总RR，1.10; 95% CI，0.95 - 1.28），除了非美国研究（5项研究，汇总RR=1.17，95% CI，1.04 - 1.33）。镇痛药摄入量越高，风险也会增加。在这项迄今为止最大的荟萃分析中，我们发现对乙酰氨基酚和非阿司匹林NSAID与患肾癌的显著风险相关。需要进一步的工作来阐明这些发现背后的生物学机制。
Analgesics are the most commonly used over-the-counter drugs worldwide with certain analgesics having cancer prevention effect. The evidence for an increased risk of developing kidney cancer with analgesic use is mixed. Using a meta-analysis design of available observational epidemiologic studies, we investigated the association between analgesic use and kidney cancer risk. We searched the MEDLINE and EMBASE databases to identify eligible case-control or cohort studies published in English until June 2012 for 3 categories of analgesics: acetaminophen, aspirin or other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Study-specific effect estimates were pooled to compute an overall relative risk (RR) and its 95% confidence interval (CI) using a random effects model for each category of the analgesics. We identified 20 studies (14 with acetaminophen, 13 with aspirin, and 5 with other NSAIDs) that were performed in 6 countries, including 8,420 cases of kidney cancer. Use of acetaminophen and non-aspirin NSAIDs were associated with an increased risk of kidney cancer (pooled RR, 1.28; 95% CI, 1.15 to 1.44 and 1.25; 95% CI, 1.06 to 1.46, respectively). For aspirin use, we found no overall increased risk (pooled RR, 1.10; 95% CI, 0.95 to 1.28), except for non-US studies (5 studies, pooled RR=1.17, 95% CI, 1.04 to 1.33). Similar increases in risks were seen with higher analgesic intake. In this largest meta-analysis to date, we found that acetaminophen and non-aspirin NSAIDs are associated with a significant risk of developing kidney cancer. Further work is needed to elucidate biologic mechanisms behind these findings.
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影响因子：
6.4
作者：
Friis, S;Nielsen, GL;Olsen, JH
通讯作者：
Olsen, JH
影响因子：
6.4
作者：
CHOW, WH;MCLAUGHLIN, JK;MANDEL, JS
通讯作者：
MANDEL, JS
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
8.8
作者：
Gago-Dominguez, M;Yuan, JM;Yu, MC
通讯作者：
Yu, MC
影响因子：
10.3
作者：
Jacobs, Eric J.;Thun, Michael J.;Calle, Eugenia E.
通讯作者：
Calle, Eugenia E.