Nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric adenocarcinomas in Los Angeles County
Nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric adenocarcinomas in Los Angeles County
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DOI：
10.1158/1055-9965.epi-07-0664
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发表时间：
2008-01-01
影响因子：
3.8
通讯作者：
Bernstein, Leslie
中科院分区：
文献类型：
--
作者：
Duan, Lei;Wu, Anna H.;Bernstein, Leslie
背景资料：非甾体类抗炎药（NSAID）的使用与结肠癌风险降低相关;进一步的流行病学数据似乎与胃癌和食管腺癌一致。然而，上消化道（UGI）疾病对腺癌的UGI的潜在混杂效应的数据是limited.Methods：本研究招募了新诊断的食管腺癌患者（n = 220），贲门腺癌（n = 277），远端胃腺癌（n = 441），以及1,356名对照组在洛杉矶县。非条件多变量逻辑回归分析进行评估之间的关联定期使用非甾体抗炎药，每周至少两片，1个月，和这些cancer.Results：持续定期使用阿司匹林和非阿司匹林非甾体抗炎药与远端胃腺癌的相对风险降低[> 5年使用与不定期用途：优势比（OR），0.61; 95%置信区间，0.40-0.92; P-趋势= 0.0091和食管腺癌（OR，0.60; 95%置信区间，0.38-0.95; P-趋势= 0.04），多变量模型包括UGI疾病史和其他潜在混杂因素。每日定期使用也与这两种肿瘤类型的OR统计学显著降低相关。在任何研究中心，按上消化道疾病史分层后，未发现风险估计的显著异质性。然而，非甾体类抗炎药的不规则用户也降低了这些癌症的风险时，相比nonusers.Conclusions：本研究的结果支持定期NSAID的使用和食管和远端胃腺癌的风险之间的负相关，在个人和没有UGI疾病的历史，长期和日常使用，提供最大的风险降低。不规则使用者的风险降低表明，除了对环氧合酶的影响之外，其他因素也可能很重要。
Background: Nonsteroidal anti-inflammatory drug (NSAID) use has been associated with a reduced risk of colon cancer; further epidemiologic data appear consistent for stomach and esophageal adenocarcinomas. Yet, data on potential confounding effects by upper gastrointestinal tract (UGI) disorders on adenocarcinomas of the UGI are limited.Methods: This study recruited newly diagnosed patients with esophageal adenocarcinoma (n = 220), gastric cardia adenocarcinoma (n = 277), or distal gastric adenocarcinoma (n = 441) as well as 1,356 control subjects in Los Angeles County. Unconditional multivariable logistic regression analyses were done to evaluate the association between regular NSAID use, at least two pills per week for 1 month, and these cancers.Results: Duration of regular use of aspirin and nonaspirin NSAIDs was associated with reduced relative odds of distal gastric adenocarcinoma [> 5 years use versus no regular use: odds ratio (OR), 0.61; 95% confidence interval, 0.40-0.92; P-trend = 0.0091 and esophageal adenocarcinoma (OR, 0.60; 95% confidence interval, 0.38-0.95; P-tnend = 0.04) in multivariable models that included history of UGI disorders and other potential confounding factors. Daily regular use was also associated with statistically significant reduced ORs of these two tumor types. No significant heterogeneity in risk estimates was noted after stratification by history of UGI disorders for any of the sites studied. However, irregular users of NSAIDs also had reduced risk of these cancers when compared with nonusers.Conclusions: Results from this study support an inverse association between regular NSAID use and risk of esophageal and distal gastric adenocarcinomas in individuals with and without a history of UGI disorders with long duration and daily use, providing the greatest risk reduction. Reduced risk in irregular users suggests that factors other than an effect on cyclooxygenase may also be important.