Mangiapane Sandra, Blettner Maria, Schlattmann Peter
Technical University of Berlin, Department of Technology and Management, Berlin, Germany.
Pharmacoepidemiol Drug Saf. 2008 Feb;17(2):115-24. doi: 10.1002/pds.1503.
To examine the recent epidemiological studies on aspirin use and breast cancer risk published from 2001 to 2005 within a meta-analysis, to investigate reasons for heterogeneity between the individual studies and to analyse a dose-response-relationship considering frequency and duration of use.
We systematically searched for cohort-studies and case-control-studies from 2001-2005, which evaluated the association between aspirin and breast cancer risk. We calculated a pooled estimate for the relative risk (RR) and investigated reasons for heterogeneity between the individual studies and analysed a dose-response-relationship using random effects mixed models.
We identified 10 studies which met the inclusion criteria. The combined estimate of the RR was 0.75 (95%CI: 0.64, 0.88) using the random effects model. Heterogeneity between the studies could not be explained by the covariates study-type and study-population. The combination of frequency and duration of aspirin use resulted in a significant dose-response-relationship between aspirin use and breast cancer risk. Each additional pillyear reduced the breast cancer risk to about 2%.
Our meta-analysis supports the current evidence that aspirin may reduce breast cancer risk. Moreover, a dose-response-relationship seems to exist. However, results have to be interpreted carefully, as exposure categories were defined very heterogeneously among the studies which weakens the validity of the pooled estimates.
在一项荟萃分析中审视2001年至2005年发表的关于阿司匹林使用与乳腺癌风险的近期流行病学研究,探究各独立研究之间异质性的原因,并分析考虑使用频率和持续时间的剂量反应关系。
我们系统检索了2001年至2005年评估阿司匹林与乳腺癌风险之间关联的队列研究和病例对照研究。我们计算了相对风险(RR)的合并估计值,探究各独立研究之间异质性的原因,并使用随机效应混合模型分析剂量反应关系。
我们确定了10项符合纳入标准的研究。使用随机效应模型,RR的合并估计值为0.75(95%置信区间:0.64,0.88)。研究类型和研究人群等协变量无法解释研究之间的异质性。阿司匹林使用频率和持续时间的综合作用导致阿司匹林使用与乳腺癌风险之间存在显著的剂量反应关系。每增加一个 pill 年,乳腺癌风险降低约2%。
我们的荟萃分析支持当前证据,即阿司匹林可能降低乳腺癌风险。此外,似乎存在剂量反应关系。然而,由于各研究中暴露类别定义差异很大,削弱了合并估计值的有效性,因此对结果必须谨慎解读。