García Rodríguez Luis A, González-Pérez Antonio
Centro Español de Investigación Farmacoepidemiológica (CEIFE), Almirante 28-2, 28004 Madrid, Spain.
Cancer Epidemiol Biomarkers Prev. 2004 Apr;13(4):649-53.
Prostate cancer is considered a major health problem in western countries. Promising results from observational studies on cancer at other sites fuelled the publication of several studies assessing the association between nonsteroidal anti-inflammatory drug (NSAID) use and prostate cancer. However, these studies show conflicting results.
We conducted a cohort study with a nested case-control analysis to further study the association between NSAIDs and prostate cancer. We used data from the General Practice Research Database in United Kingdom.
Aspirin use was associated with a reduced risk of prostate cancer [odds ratio (OR) = 0.70, 95% confidence interval (95% CI) = 0.61-0.79]. We also found that paracetamol use with a treatment duration longer than 1 year was associated with a decreased risk (OR = 0.65, 95% CI = 0.54-0.78). Non-aspirin-NSAID (NA-NSAID) and paracetamol short-term use was associated with a small increased risk whereas long-term users of NA-NSAIDs presented an OR of 0.89 (95% CI = 0.73-1.08).
Our findings support a protective effect of aspirin and paracetamol against prostate cancer. The transient elevated risk observed among newly started users of NA-NSAIDs and paracetamol is most likely explained by prothopathic bias. We found some suggestion of a reduced risk with long-term use of NA-NSAID.
前列腺癌在西方国家被视为一个重大的健康问题。其他部位癌症观察性研究取得的 promising results 促使发表了几项评估非甾体抗炎药（NSAID）使用与前列腺癌之间关联的研究。然而，这些研究结果相互矛盾。
我们进行了一项队列研究，并进行巢式病例对照分析，以进一步研究 NSAID 与前列腺癌之间的关联。我们使用了英国全科医疗研究数据库的数据。
使用阿司匹林与前列腺癌风险降低相关[比值比（OR）=0.70，95%置信区间（95%CI）=0.61 - 0.79]。我们还发现，使用对乙酰氨基酚且治疗持续时间超过 1 年与风险降低相关（OR = 0.65，95%CI = 0.54 - 0.78）。非阿司匹林类 NSAID（NA - NSAID）和对乙酰氨基酚短期使用与风险小幅增加相关，而 NA - NSAIDs 的长期使用者的 OR 为 0.89（95%CI = 0.73 - 1.08）。
我们的研究结果支持阿司匹林和对乙酰氨基酚对前列腺癌的保护作用。新开始使用 NA - NSAIDs 和对乙酰氨基酚的人群中观察到的短暂风险升高很可能是由患病偏倚所致。我们发现了一些长期使用 NA - NSAID 风险降低的迹象。
