Coogan P F, Rosenberg L, Palmer J R, Strom B L, Zauber A G, Stolley P D, Shapiro S
Slone Epidemiology Unit, Boston University School of Medicine, Brookline, Massachusetts 02446, USA.
Cancer Epidemiol Biomarkers Prev. 2000 Jan;9(1):119-23.
Regular continuing nonsteroidal anti-inflammatory drug (NSAID) use has been associated with a reduction in risk of large bowel cancer in many studies, including our Case-Control Surveillance Study of medication use and cancer risk. We assessed the relation of NSAID use to the risk of digestive cancers at sites other than the large bowel in this database. Nurse-interviewers administered questionnaires to patients admitted to hospitals in four centers from 1977 to 1998. Cases comprised 1149 patients with cancers of the pancreas (n = 504), stomach (n = 254), esophagus (n = 215), gallbladder (n = 125), or liver (n = 51). Controls were 5952 patients admitted for trauma or acute infection. History of NSAID use was elicited by questions about indications for use. Multiple logistic regression models were used to calculate odds ratios (ORs) for categories of regular NSAID use (at least 4 days/week for at least 3 months) relative to never use. The OR for regular use initiated at least 1 year before admission and continuing into that year was reduced for stomach cancer (OR = 0.3; 95% confidence interval, 0.1-0.6) and was compatible with 1.0 for other sites. The ORs for regular continuing use of at least 5 years duration were < 1.0 for cancers of the stomach, pancreas, esophagus, and gallbladder but were statistically significant only for stomach cancer. These data suggest that regular continuing NSAID use may be associated with reduced risk of stomach cancer. For the other sites, the data are consistent with no effect of NSAID use.
在包括我们关于药物使用与癌症风险的病例对照监测研究在内的许多研究中，长期持续使用非甾体抗炎药（NSAID）与降低患大肠癌的风险相关。我们在该数据库中评估了NSAID使用与大肠以外部位消化系统癌症风险的关系。1977年至1998年期间，护士访视员向四个中心医院收治的患者发放问卷。病例包括1149例患有胰腺癌（n = 504）、胃癌（n = 254）、食管癌（n = 215）、胆囊癌（n = 125）或肝癌（n = 51）的患者。对照组为5952例因创伤或急性感染入院的患者。通过询问使用指征来了解NSAID使用史。使用多元逻辑回归模型计算长期使用NSAID（至少每周4天，至少3个月）相对于从未使用者的比值比（OR）。入院前至少1年开始并持续到当年的长期使用者中，胃癌的OR降低（OR = 0.3；95%置信区间，0.1 - 0.6），其他部位的OR与1.0相当。持续使用至少5年的长期使用者中，胃癌、胰腺癌、食管癌和胆囊癌的OR < 1.0，但仅胃癌具有统计学意义。这些数据表明，长期持续使用NSAID可能与降低胃癌风险相关。对于其他部位，数据表明NSAID使用无影响。
