CASE CONTROL STUDY OF STATIN USE AND LARGE BOWEL CANCER

描述（改编自申请人的摘要）：大肠癌是一种 是美国癌症发病率和死亡率的主要原因。我们 以前的流行病学研究在证明一种相反的 阿司匹林和其他非甾体抗炎药的使用之间的关联 非甾体类抗炎药（NSAIDS）和大肠癌的发病率。这些研究是 受实验室数据的启发， 致癌作用现在，越来越多的实验室数据表明， 常用的，相对较新的一类降胆固醇药物， “他汀类药物”可能具有类似的化学预防潜力：他汀类药物可抑制 结肠癌细胞在体外和体内的生长。也有一些证据 他汀类药物可能增强NSAIDS的化学预防作用。他汀类药物 (e.g.,洛伐他汀、辛伐他汀）于1987年首次上市，现在已成为 美国最常用的处方药在这个时候有 关于其潜在的保护作用的流行病学数据很少 大肠癌两项关于他汀类药物预防 冠心病患者中大肠癌的发病率无显著性差异， 治疗组。 我们建议在马萨诸塞州进行一项基于人群的病例对照研究， 他汀类药物的使用与大肠癌风险的关系。我们将确定 2050例50-74岁的事件病例通过参与医院和2050例年龄， 性别和选区匹配社区控制从马萨诸塞州镇名单。 将对病例和对照进行访谈，以获得人口统计学信息。 因素，大肠癌的风险因素，他汀类药物的详细病史， NSAID的使用，以及对解决潜在偏倚有用的数据。这项研究很大 足以评估他汀类药物使用的特征的影响（时机， 持续时间，剂量）对大肠癌风险的影响，并评估 年龄、性别和癌症部位亚组的研究结果。的共同作用 还将评估他汀类药物和NSAID。 拟议的研究将提供关于潜在的流行病学数据， 大肠癌的化学预防。因为这种疾病的发病率和 美国男性和女性使用他汀类药物的流行率都很高， 将具有相当大的公共卫生重要性。此外，它会脱落 阐明结肠癌发生的机制。

DESCRIPTION (Adapted from applicant's abstract): Cancer of the large bowel is a leading cause of cancer morbidity and mortality in the United States. Our previous epidemiologic studies played a key role in documenting an inverse association between the use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS) and the incidence of large bowel cancer. Those studies were inspired by laboratory data suggesting that NSAIDs may reduce colon carcinogenesis. Now a growing body of laboratory data indicates that the commonly used, relatively new class of cholesterol-lowering drugs, the "statins" may have a similar chemopreventive potential: statins inhibit the growth of colon cancer cells in vitro and in vivo. There is also some evidence that statins may enhance the chemopreventive effect of NSAIDS. The statins (e.g., lovastatin, simvastatin) were first marketed in 1987, and are now among the most commonly prescribed drugs in the United States. At this time there is little epidemiologic data concerning their potential protective effect against large bowel cancer. Two randomized trials of statin use as preventives of coronary heart disease had nonsignificant deficits of large bowel cancer in the treated groups. We propose to conduct a population-based case-control study in Massachusetts of the relation of statin use to the risk of large bowel cancer. We will identify 2050 incident cases aged 50-74 through participating hospitals and 2050 age, sex, and precinct matched community controls from Massachusetts town lists. Cases and controls will be interviewed to obtain information on demographic factors, risk factors for large bowel cancer, detailed histories of statin and NSAID use, and data useful for addressing potential biases. The study is large enough to assess the influence of characteristics of statin use (timing, duration, dose) on the risk of large bowel cancer and to assess consistency of findings across subgroups of age, sex, and cancer site. The joint effect of statins and NSAIDs will also be assessed. The proposed study will provide informative epidemiologic data on a potential chemopreventive of large bowel cancer. Because the incidence of the disease and prevalence of statin use by U.S. men and women are high, an inverse association would be of considerable public health importance. Moreover, it would shed light on a mechanism of colon carcinogenesis.