Gago-Dominguez M, Yuan J M, Castelao J E, Ross R K, Yu M C
Department of Preventive Medicine, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles 90033-0800, USA.
Br J Cancer. 1999 Oct;81(3):542-8. doi: 10.1038/sj.bjc.6690728.
Phenacetin-based analgesics have been linked to the development of renal pelvis cancer and renal cell carcinoma (RCC). The relationship between non-phenacetin types of analgesics and kidney cancer is less clear, although laboratory evidence suggests that these drugs possess carcinogenic potential. A population-based case-control study involving 1204 non-Asian RCC patients aged 25-74 and an equal number of sex-, age- and race-matched neighbourhood controls was conducted in Los Angeles, California, to investigate the relationship between sustained use of analgesics and risk of RCC according to major formulation categories. Detailed information on medical and medication histories, and other lifestyle factors was collected through in-person interviews. Regular use of analgesics was a significant risk factor for RCC in both men and women (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.4-1.9 for both sexes combined). Risks were elevated across all four major classes of analgesics (aspirin, non-steroidal anti-inflammatory agents other than aspirin, acetaminophen and phenacetin). Within each class of analgesics, there was statistically significant increasing risk with increasing level of exposure. Although there was some minor variability by major class of formulation, in general individuals in the highest exposure categories exhibited approximately 2.5-fold increase in risk relative to non- or irregular users of analgesics. Subjects who took one regular-strength (i.e. 325 mg) aspirin a day or less for cardiovascular disease prevention were not at an increased risk of RCC (OR = 0.9, 95% CI = 0.6-1.4).
基于非那西丁的镇痛药与肾盂癌和肾细胞癌（RCC）的发生有关。非那西丁类镇痛药与肾癌之间的关系尚不清楚，尽管实验室证据表明这些药物具有致癌潜力。在加利福尼亚州洛杉矶进行了一项基于人群的病例对照研究，该研究纳入了1204名年龄在25 - 74岁之间的非亚洲RCC患者以及数量相等的性别、年龄和种族匹配的社区对照，以根据主要剂型类别研究持续使用镇痛药与RCC风险之间的关系。通过面对面访谈收集了有关医疗和用药史以及其他生活方式因素的详细信息。定期使用镇痛药是男性和女性患RCC的重要危险因素（合并两性的比值比（OR）= 1.6，95%置信区间（CI）= 1.4 - 1.9）。在所有四类主要镇痛药（阿司匹林、非阿司匹林类非甾体抗炎药、对乙酰氨基酚和非那西丁）中风险均有所升高。在每类镇痛药中，随着暴露水平的增加，风险在统计学上有显著增加。尽管按主要剂型类别存在一些微小差异，但总体而言，最高暴露类别的个体相对于不使用或不定期使用镇痛药的个体，风险增加了约2.5倍。为预防心血管疾病而每天服用一片常规剂量（即325毫克）或更少阿司匹林的受试者患RCC的风险并未增加（OR = 0.9，95% CI = 0.6 - 1.4）。
