Sørensen H T, Friis S, Nørgård B, Mellemkjaer L, Blot W J, McLaughlin J K, Ekbom A, Baron J A
Department of Clinical Epidemiology, Aarhus University and Aalborg Hospital, Vennelyst Boulevard 6, Building 260, Denmark.
Br J Cancer. 2003 Jun 2;88(11):1687-92. doi: 10.1038/sj.bjc.6600945.
There is increasing evidence of an inverse association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and risk of colorectal cancer. However, data regarding other cancer sites are limited. Using data from the population-based North Jutland Prescription Database and the Danish Cancer Registry, we compared cancer incidence among 172 057 individuals prescribed nonaspirin NSAIDs with expected incidence (based on county-specific cancer rates) during a 9-year study period. A total of 6081 incident cancer cases were diagnosed among NSAID users vs 5722 expected (standardised incidence ratio (SIR) 1.1, 95% confidence interval (CI)1.0-1.1). The SIRs for colon and rectal cancer among persons who obtained 10 or more prescriptions were 0.7 (95% CI 0.6-0.9) and 0.6 (95% CI 0.4-0.9), respectively. Similarly, reduced risk estimates were found for stomach (SIR 0.7, 95% CI 0.4-1.1) and ovarian cancer (SIR 0.7, 95% CI 0.4-1.0). Standardised incidence ratios for other cancers among those with 10 or more prescriptions tended to be close to 1.0, except for lung, kidney, and prostate cancers with SIRs of 1.3 (95% CI 1.1-1.6), 1.4 (95% CI 0.9-2.1), and 1.6 (95% CI 1.3-2.0), respectively. We found protective associations of NSAIDs against colon, rectal, stomach, and ovarian cancer. Reasons for the increased risk for some cancer sites are not clear.
越来越多的证据表明，使用非甾体抗炎药（NSAIDs）与结直肠癌风险之间存在负相关。然而，关于其他癌症部位的数据有限。利用基于人群的北日德兰处方数据库和丹麦癌症登记处的数据，我们比较了172057名开具非阿司匹林NSAIDs处方的个体在9年研究期间的癌症发病率与预期发病率（基于特定县的癌症发病率）。NSAIDs使用者中总共诊断出6081例新发癌症病例，而预期为5722例（标准化发病率（SIR）为1.1，95%置信区间（CI）为1.0 - 1.1）。获得10张或更多处方的人群中，结肠癌和直肠癌的SIR分别为0.7（95%CI 0.6 - 0.9）和0.6（95%CI 0.4 - 0.9）。同样，胃癌（SIR 0.7，95%CI 0.4 - 1.1）和卵巢癌（SIR 0.7，95%CI 0.4 - 1.0）的风险估计也降低。开具10张或更多处方的人群中，除肺癌、肾癌和前列腺癌的SIR分别为1.3（95%CI 1.1 - 1.6）、1.4（95%CI 0.9 - 2.1）和1.6（95%CI 1.3 - 2.0）外，其他癌症的标准化发病率往往接近1.0。我们发现NSAIDs对结肠癌、直肠癌、胃癌和卵巢癌具有保护作用。某些癌症部位风险增加的原因尚不清楚。
