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非甾体抗炎药的使用与乳腺癌风险:对病例对照监测研究的再探讨

Use of nonsteroidal antiinflammatory drugs and risk of breast cancer: the Case-Control Surveillance Study revisited.

作者信息

Zhang Yuqing, Coogan Patricia F, Palmer Julie R, Strom Brian L, Rosenberg Lynn

机构信息

Clinical Epidemiology Research and Training Unit, School of Medicine, Boston University, Boston, MA 02118, USA.

出版信息

Am J Epidemiol. 2005 Jul 15;162(2):165-70. doi: 10.1093/aje/kwi182. Epub 2005 Jun 22.

Abstract

Several studies have suggested that use of nonsteroidal antiinflammatory drugs (NSAIDs) may reduce the risk of breast cancer. Reductions in risk may vary according to the hormone receptor status of the tumor or the type of NSAID used. The authors extended a previous US hospital-based case-control study (the Case-Control Surveillance Study) to include 444 additional cases, for a total of 7,006 incident breast cancer cases (1976-2002). They examined the relation between regular NSAID use and breast cancer risk using logistic regression to adjust for confounding. The odds ratio for regular use of NSAIDs was 0.78 (95% confidence interval: 0.63, 0.97), and a trend of decreasing risk with increasing duration of use was statistically significant (p for trend = 0.02). The inverse association with regular use of NSAIDs was stronger among premenopausal women (odds ratio = 0.62). The overall odds ratios for regular use of aspirin and ibuprofen were 0.86 and 0.85, respectively. The effect of NSAID use on breast cancer risk did not vary according to the hormone receptor status of the tumor. In conclusion, long-term regular use of NSAIDs was associated with decreased risk of breast cancer. The type of NSAID used or the hormone receptor status of the tumor did not modify the effect.

摘要

多项研究表明,使用非甾体抗炎药(NSAIDs)可能会降低患乳腺癌的风险。风险降低程度可能因肿瘤的激素受体状态或所使用的NSAID类型而异。作者扩展了之前一项基于美国医院的病例对照研究(病例对照监测研究),新增了444例病例,使病例总数达到7006例(1976 - 2002年)。他们使用逻辑回归分析来调整混杂因素,研究了规律使用NSAIDs与乳腺癌风险之间的关系。规律使用NSAIDs的比值比为0.78(95%置信区间:0.63,0.97),并且随着使用时间延长风险降低的趋势具有统计学意义(趋势检验p值 = 0.02)。绝经前女性中规律使用NSAIDs与风险的负相关更强(比值比 = 0.62)。规律使用阿司匹林和布洛芬的总体比值比分别为0.86和0.85。NSAIDs使用对乳腺癌风险的影响并不因肿瘤的激素受体状态而有所不同。总之,长期规律使用NSAIDs与乳腺癌风险降低相关。所使用的NSAID类型或肿瘤的激素受体状态并未改变这种影响。

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