Harris Randall E, Chlebowski Rowan T, Jackson Rebecca D, Frid David J, Ascenseo Joao L, Anderson Garnet, Loar Aimee, Rodabough Rebecca J, White Emily, McTiernan Anne
The Ohio State University College of Medicine and Public Health, Columbus, Ohio 43210-1240, USA.
Cancer Res. 2003 Sep 15;63(18):6096-101.
We analyzed data from the prospective Women's Health Initiative (WHI) Observational Study to examine the effects of regular use of aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) on breast cancer risk. We studied a population of 80,741 postmenopausal women between 50 and 79 years of age who reported no history of breast cancer or other cancers (excluding nonmelanoma skin cancer), and we completed a personal baseline interview that elicited comprehensive health information including data on breast cancer risk factors and NSAID use. All of the cases were adjudicated by WHI physicians using pathology reports. Our analysis was based on 1392 confirmed cases of breast cancer. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated with adjustment for age and other breast cancer risk factors. Regular NSAID use (two or more tablets/week) for 5-9 years produced a 21% reduction in the incidence of breast cancer (RR, 0.79; 95% CI, 0.60-1.04); regular NSAID use for 10 or more years produced a 28% reduction (RR, 0.72; CI, 0.56-0.91), and there was a statistically significant inverse linear trend of breast cancer incidence with the duration of NSAID use (P < 0.01). The estimated risk reduction for long-term use of ibuprofen (RR, 0.51; CI, 0.28-0.96) was greater than for aspirin (RR, 0.79; CI, 0.60-1.03). Subgroup analysis by breast cancer risk factors did not result in effect modification. Regular use of acetaminophen (an analgesic agent with little or no anti-inflammatory activity) or low-dose aspirin (<100 mg) was unrelated to the incidence of breast cancer. Our results indicate that the regular use of aspirin, ibuprofen, or other NSAIDs may have a significant chemopreventive effect against the development of breast cancer and underscore the need for clinical trials to confirm this effect.
我们分析了前瞻性女性健康倡议（WHI）观察性研究的数据，以检验定期使用阿司匹林、布洛芬和其他非甾体抗炎药（NSAIDs）对乳腺癌风险的影响。我们研究了80741名年龄在50至79岁之间的绝经后女性，她们均无乳腺癌或其他癌症病史（非黑色素瘤皮肤癌除外），并完成了一次个人基线访谈，获取了包括乳腺癌风险因素和NSAIDs使用情况在内的全面健康信息。所有病例均由WHI医生根据病理报告进行判定。我们的分析基于1392例确诊的乳腺癌病例。通过对年龄和其他乳腺癌风险因素进行调整，估计了相对风险（RRs）及95%置信区间（CIs）。定期使用NSAIDs（每周两片或更多）5至9年可使乳腺癌发病率降低21%（RR，0.79；95%CI，0.60 - 1.04）；定期使用NSAIDs 10年或更长时间可使发病率降低28%（RR，0.72；CI，0.56 - 0.91），并且乳腺癌发病率随NSAIDs使用时间呈显著的负线性趋势（P < 0.01）。长期使用布洛芬的估计风险降低幅度（RR，0.51；CI，0.28 - 0.96）大于阿司匹林（RR，0.79；CI，0.60 - 1.03）。按乳腺癌风险因素进行的亚组分析未导致效应修正。定期使用对乙酰氨基酚（一种几乎没有抗炎活性的镇痛药）或低剂量阿司匹林（<100毫克）与乳腺癌发病率无关。我们的结果表明，定期使用阿司匹林、布洛芬或其他NSAIDs可能对乳腺癌的发生具有显著的化学预防作用，并强调需要进行临床试验来证实这一作用。
