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Analgesic Use and Kidney Cancer

镇痛药的使用和肾癌

基本信息

批准号：
7691801
负责人：
EUNYOUNG CHO
金额：
$ 8.71万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-24 至 2011-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7691801
关键词：
Accounting Acetaminophen Address Affect Analgesics Anti-Inflammatory Agents Anti-inflammatory Apoptosis Aspirin Biological Cardiovascular Diseases Case-Control Studies Cell Proliferation Chronic Chronic Kidney Failure Cohort Analysis Cohort Studies Colorectal Cancer Complement Data Data Set Diagnosis Disease Drug usage Etiology Female Follow-Up Studies Genetic Health Professional Hypertension Ibuprofen Incidence Individual Inflammation Kidney Literature Malignant - descriptor Malignant Neoplasms Meta-Analysis Non-Prescription Drugs Nurses&apos Health Study Obesity Pain Participant Pelvic Cancer Pharmaceutical Preparations Prospective Studies Public Health Publications Renal Cell Carcinoma Renal carcinoma Renal function Renal pelvis Research Design Risk Risk Factors Role Smoking Surveys Time Woman Work cancer cell cancer prevention cancer risk carcinogenesis case control cost epidemiologic data insight male men non-drug prospective protective effect

项目摘要

DESCRIPTION (provided by applicant): Kidney cancer is the 7th leading malignant condition among men and the 9th among women, accounting for 4% of all cancers. The majority of kidney cancer is renal cell cancer (RCC), with the remainder of cases mostly renal pelvis cancer. The incidence of kidney cancer has been rising in the U.S. and worldwide. Nevertheless, the etiology of this malignancy is largely unexplored. Analgesics are a diverse group of drugs used to relieve pain, including acetaminophen and non-steroidal anti- inflammatory drugs (NSAIDs). The NSAID aspirin is one of the most commonly used drugs in the U.S. and is well-known for its protective effect against cardiovascular disease and colorectal cancer. Aspirin may reduce kidney cancer by reducing inflammation, inhibiting cycloxygenase-2, inhibiting cell proliferation, and inducing apoptosis of cancer cells. However, limited epidemiologic data are available, with few prospective data for analgesic use and kidney cancer risk. Furthermore, previous case-control studies on analgesic use and kidney cancer risk point toward a positive association. In fact, some analgesics such as acetaminophen may contribute to decline of renal function and elevated risk of chronic renal disease and, subsequently, to elevated risk of kidney cancer. Thus, given the popularity of aspirin and other analgesics, clarification of the association is necessary from a public health standpoint. In this application, we will determine the effects of individual and total analgesic use on the risk of kidney cancer. We hypothesize that use of aspirin and other NSAIDs is associated with a reduced risk of kidney cancer, but that use of acetaminophen is associated with an elevated risk of kidney cancer. We will evaluate these hypotheses using two different study designs; 1) in large prospective studies of male and female with 430 kidney cancer cases (350 RCC) and 2) in a meta-analysis of previous literature including both case-control and cohort studies with over 5,600 kidney cancer cases. These two study designs will complement the strength of each study design. We believe that this proposed work will provide the best available data on analgesic use and kidney cancer risk and substantially enhance our understanding of the role of analgesics in renal carcinogenesis. Our findings will provide insights into the biological mechanisms potentially underlying these associations. Because of the popularity of aspirin and other analgesics, this proposed work has substantial public health implications.

描述(申请人提供)：肾癌在男性中排名第7位，在女性中排名第9位，占所有癌症的4%。大多数肾癌是肾细胞癌(RCC)，其余病例大多是肾盆癌。肾癌的发病率在美国和世界范围内一直在上升。然而，这种恶性肿瘤的病因在很大程度上还没有被探索出来。止痛药是用于缓解疼痛的多种药物，包括对乙酰氨基酚和非类固醇抗炎药(NSAIDs)。非甾体抗炎药阿司匹林是美国最常用的药物之一，因其对心血管疾病和结直肠癌的保护作用而闻名。阿司匹林可能通过减轻炎症、抑制环氧合酶-2、抑制细胞增殖和诱导癌细胞凋亡来减轻肾癌。然而，可获得的流行病学数据有限，几乎没有关于止痛药使用和肾癌风险的前瞻性数据。此外，先前关于止痛药使用与肾癌风险的病例对照研究指出两者之间存在正相关关系。事实上，一些镇痛剂，如扑热息痛，可能会导致肾功能下降和慢性肾脏疾病风险增加，从而增加患肾癌的风险。因此，考虑到阿司匹林和其他止痛药的流行，从公共卫生的角度来看，澄清这种联系是必要的。在这项应用中，我们将确定单独使用和全部使用止痛剂对肾癌风险的影响。我们假设阿司匹林和其他非甾体抗炎药的使用与肾癌风险的降低有关，但扑热息痛的使用与肾癌的风险增加相关。我们将使用两种不同的研究设计来评估这些假设：1)在430例肾癌(350例肾癌)男性和女性的大型前瞻性研究中；2)在先前文献的荟萃分析中，包括5600多例肾癌病例的病例对照和队列研究。这两个研究设计将补充每个研究设计的优势。我们相信，这项拟议的工作将提供关于止痛药使用和肾癌风险的最佳可用数据，并大大增强我们对止痛药在肾癌发生中的作用的理解。我们的发现将为这些联系潜在的生物学机制提供洞察力。由于阿司匹林和其他止痛药的流行，这项拟议的工作具有重大的公共健康影响。