Cotterchio M, Kreiger N, Sloan M, Steingart A
Division of Preventive Oncology, Research Unit, Cancer Care Ontario, Canada.
Cancer Epidemiol Biomarkers Prev. 2001 Nov;10(11):1213-7.
Findings from previous epidemiological studies are inconclusive, though they suggest nonsteroidal anti-inflammatory drug (NSAID) use is associated with a reduction in breast cancer risk. In addition, animal studies report that NSAIDs inhibit mammary tumor development. The association between NSAID use and breast cancer risk was evaluated using a case-control study design. Cases were a random sample of women diagnosed with a first primary cancer of the breast, aged 25-74 years, identified through the Ontario Cancer Registry, and diagnosed between July 1996 and September 1998. Controls were an age-matched random sample of the female population of Ontario. Cases (n = 3133) and controls (n = 3062) completed a mailed questionnaire with information on their past use of NSAID and other medications, as well as many risk factors thought to be associated with breast cancer. Multivariate logistic regression analysis was used to obtain adjusted odds ratio (OR) estimates. Use of any NSAID medication (daily use for > or =2 months) was found to be associated with a significant 24% reduction in breast cancer risk (OR = 0.76; 95% confidence interval: 0.66, 0.88). The reduced risk was strongest for use lasting > 8 years, compared with nonusers (OR = 0.68; 95% confidence interval: 0.54, 0.86). No marked trends were observed for time since first use or last use or age at first use. Our results suggest a reduction in breast cancer risk associated with any regular NSAID use. NSAID use is a modifiable factor, and any protective effect attributed to its use could be of great public health importance.
以往流行病学研究的结果尚无定论，不过这些研究表明，使用非甾体抗炎药（NSAID）与乳腺癌风险降低有关。此外，动物研究报告称，NSAIDs可抑制乳腺肿瘤的发展。本研究采用病例对照研究设计评估了NSAID使用与乳腺癌风险之间的关联。病例为通过安大略癌症登记处确定的、年龄在25至74岁之间、被诊断为原发性乳腺癌的女性随机样本，诊断时间为1996年7月至1998年9月。对照为安大略女性人群中年龄匹配的随机样本。病例（n = 3133）和对照（n = 3062）完成了一份邮寄问卷，问卷内容包括她们过去使用NSAID和其他药物的情况，以及许多被认为与乳腺癌相关的风险因素。采用多因素逻辑回归分析来获得调整后的比值比（OR）估计值。结果发现，使用任何NSAID药物（每日使用≥2个月）与乳腺癌风险显著降低24%相关（OR = 0.76；95%置信区间：0.66，0.88）。与未使用者相比，使用时间超过8年的风险降低最为显著（OR = 0.68；95%置信区间：0.54，0.86）。首次使用或最后使用后的时间以及首次使用时的年龄均未观察到明显趋势。我们的结果表明，定期使用任何NSAID与乳腺癌风险降低有关。NSAID的使用是一个可改变的因素，其使用所带来的任何保护作用可能具有重大的公共卫生意义。
