Genkinger Jeanine M, De Vivo Immaculata, Stampfer Meir J, Giovannucci Edward, Michaud Dominique S
Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Int J Cancer. 2007 May 15;120(10):2221-5. doi: 10.1002/ijc.22546.
Nonsteroidal antiinflammatory drugs (NSAIDs) use, particularly aspirin, may lower the risk of several cancers, including bladder. NSAIDs may reduce development of bladder tumors by decreasing inflammation, inhibiting cycloxygenase-2, inhibiting proliferation and inducing apoptosis of cancer cells. However, acetaminophen, a major metabolite of phenacetin, may be positively associated with bladder cancer risk. Results from case-control studies on NSAIDs and acetaminophen use and bladder cancer risk are inconsistent. We investigated the association between NSAID and acetaminophen use and bladder cancer risk in a large cohort of US males. Among 49,448 men in the Health Professionals Follow-Up Study, 607 bladder cancer cases were confirmed during 18 years of follow-up. Relative risks (RR) and 95% confidence intervals (CI) were calculated by Cox proportional hazards models. Multivariate RR were adjusted for age, current smoking status, pack years, geographic region and fluid intake. No significant associations were observed for regular aspirin (> or =2 tablets per week), (RR = 0.99, 95% CI 0.83-1.18), ibuprofen (RR = 1.11, 95% CI 0.81-1.54), acetaminophen (RR = 0.96, 95% CI 0.67-1.39) or total NSAID use (not including acetaminophen; RR = 1.01, 95% CI 0.85-1.20) and bladder cancer risk compared with nonuse. Consistent use (over 6 years) of aspirin, ibuprofen, acetaminophen and total NSAIDs, compared to nonuse, was not associated with bladder cancer risk. No association was observed between aspirin frequency and dose and bladder cancer risk. We observed no effect-modification by smoking, age or fluid intake. Our results suggest that regular NSAID or acetaminophen use has no substantial impact on bladder cancer risk among men.
非甾体抗炎药（NSAIDs）的使用，尤其是阿司匹林，可能会降低包括膀胱癌在内的几种癌症的风险。NSAIDs可能通过减轻炎症、抑制环氧化酶-2、抑制癌细胞增殖和诱导癌细胞凋亡来减少膀胱肿瘤的发生。然而，对乙酰氨基酚（非那西丁的主要代谢产物）可能与膀胱癌风险呈正相关。关于NSAIDs和对乙酰氨基酚的使用与膀胱癌风险的病例对照研究结果并不一致。我们在一大群美国男性中调查了NSAIDs和对乙酰氨基酚的使用与膀胱癌风险之间的关联。在健康专业人员随访研究的49448名男性中，在18年的随访期间确诊了607例膀胱癌病例。相对风险（RR）和95%置信区间（CI）通过Cox比例风险模型计算。多变量RR针对年龄、当前吸烟状况、吸烟包年数、地理区域和液体摄入量进行了调整。对于定期服用阿司匹林（每周≥2片）（RR = 0.99，95%CI 0.83 - 1.18）、布洛芬（RR = 1.11，95%CI 0.81 - 1.54）、对乙酰氨基酚（RR = 0.96，95%CI 0.67 - 这是一份关于非甾体抗炎药（NSAIDs）和对乙酰氨基酚与膀胱癌风险关系的研究报告。研究表明，定期使用NSAIDs或对乙酰氨基酚对男性膀胱癌风险没有实质性影响。
研究背景中提到，NSAIDs尤其是阿司匹林可能降低多种癌症风险，其作用机制包括减轻炎症、抑制环氧化酶-2、抑制癌细胞增殖和诱导凋亡等。然而，对乙酰氨基酚却可能增加膀胱癌风险，此前相关病例对照研究结果并不一致。
此次研究在美国一大群男性中展开，通过Cox比例风险模型计算相对风险和置信区间，并对年龄、吸烟状况等因素进行多变量调整。结果显示，定期服用阿司匹林、布洛芬、对乙酰氨基酚或总体NSAIDs（不包括对乙酰氨基酚）与不使用者相比，膀胱癌风险无显著关联。持续使用阿司匹林、布洛芬、对乙酰氨基酚及总体NSAIDs超过6年，与膀胱癌风险也无关联。此外，阿司匹林的服用频率和剂量与膀胱癌风险之间未观察到关联，吸烟、年龄或液体摄入量也未产生影响修饰作用。
综上所述，该研究结果表明，男性定期使用NSAIDs或对乙酰氨基酚对膀胱癌风险没有实质性影响。这一结论为相关医学研究和临床实践提供了重要参考，有助于进一步了解药物与癌症风险之间的关系，为预防和治疗膀胱癌提供科学依据。 1.39）或总体NSAIDs使用（不包括对乙酰氨基酚；RR = 1.01，95%CI 0.85 - 1.20）与不使用相比，与膀胱癌风险无显著关联。与不使用相比，持续使用（超过6年）阿司匹林、布洛芬、对乙酰氨基酚和总体NSAIDs与膀胱癌风险无关。未观察到阿司匹林频率和剂量与膀胱癌风险之间的关联。我们未观察到吸烟、年龄或液体摄入量的效应修饰作用。我们的结果表明，定期使用NSAIDs或对乙酰氨基酚对男性膀胱癌风险没有实质性影响。
