CASE CONTROL STUDY OF STATIN USE AND LARGE BOWEL CANCER

描述(摘自申请者的摘要)：结肠癌是一种 是美国癌症发病率和死亡率的主要原因。我们的 以前的流行病学研究在记录相反的情况方面发挥了关键作用 阿司匹林的使用与其他非类固醇抗炎药的关系 非甾体抗炎药(NSAIDs)和结肠癌发病率。这些研究是 实验室数据表明非类固醇抗炎药可能会减少结肠 致癌。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：他汀类药物抑制 结肠癌细胞在体内外的生长情况。也有一些证据表明 他汀类药物可能增强非甾体抗炎药的化学预防作用。他汀类药物 (如洛伐他汀、辛伐他汀)于1987年首次上市，现在属于 美国最常用的处方药。在这个时候有 关于它们潜在的预防作用的流行病学数据很少 结肠癌。他汀类药物用于预防糖尿病的两项随机试验 冠心病患者的大肠癌缺陷并不显著。 治疗组。 我们建议在马萨诸塞州进行一项以人群为基础的病例对照研究 他汀类药物的使用与大肠癌风险的关系。我们将确定 通过参与医院的2050例50-74岁和2050岁的事件， 性别和辖区与马萨诸塞州城镇名单中的社区控制相匹配。 将与病例和控制人员进行面谈，以获得有关人口统计的信息 因素，结肠癌的危险因素，他汀类药物的详细病史和 非甾体抗炎药的使用，以及对解决潜在偏见有用的数据。这项研究规模很大 足以评估他汀类药物使用特性的影响(时机， 持续时间、剂量)对结肠癌风险的影响，并评估 跨年龄、性别和癌症部位亚组的研究结果。的联合作用 他汀类药物和非甾体抗炎药也将接受评估。 这项拟议的研究将提供关于潜在的 结肠癌的化学预防。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比例很高，这是一种相反的关系 会对公共卫生有相当大的重要性。此外，它还会脱掉 关于结肠癌发生的机制。

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.