Hannibal Charlotte G, Rossing Mary Anne, Wicklund Kristine G, Cushing-Haugen Kara L
Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA 98108-1024, USA.
Am J Epidemiol. 2008 Jun 15;167(12):1430-7. doi: 10.1093/aje/kwn082. Epub 2008 Apr 4.
Analgesic use may reduce ovarian cancer risk, possibly through antiinflammatory or antigonadotropic effects. The authors conducted a population-based, case-control study in Washington State that included 812 women aged 35-74 years who were diagnosed with epithelial ovarian cancer between 2002 and 2005 and 1,313 controls. Use of analgesics, excluding use within the previous year, was assessed via in-person interviews. Logistic regression was used to calculate odds ratios and 95% confidence intervals. Overall, acetaminophen and aspirin were associated with weakly increased risks of ovarian cancer. These associations were stronger after more than 10 years of use (acetaminophen: odds ratio (OR) = 1.8, 95% confidence interval (CI): 1.3, 2.6; aspirin: OR = 1.6, 95% CI: 1.1, 2.2) and were present for indications of headache, menstrual pain, and other pain/injury. Reduced risk was observed among aspirin users who began regular use within the previous 5 years (OR = 0.6, 95% CI: 0.4, 1.0) or used this drug for prevention of heart disease (OR = 0.7, 95% CI: 0.5, 1.0). These results, in the context of prior findings, do not provide compelling evidence of a true increase in risk of ovarian cancer among women who use these drugs. However, they add to the weight of evidence that, in the aggregate, provides little support for the use of analgesic drugs as chemoprevention for this disease.
使用镇痛药可能会降低卵巢癌风险,这可能是通过抗炎或抗促性腺激素作用实现的。作者在华盛顿州开展了一项基于人群的病例对照研究,研究对象包括812名年龄在35 - 74岁之间、于2002年至2005年期间被诊断为上皮性卵巢癌的女性以及1313名对照者。通过面对面访谈评估镇痛药的使用情况(不包括前一年的使用情况)。采用逻辑回归计算比值比和95%置信区间。总体而言,对乙酰氨基酚和阿司匹林与卵巢癌风险的微弱增加有关。使用超过10年后,这些关联更强(对乙酰氨基酚:比值比(OR)= 1.8,95%置信区间(CI):1.3,2.6;阿司匹林:OR = 1.6,95% CI:1.1,2.2),且在头痛、痛经及其他疼痛/损伤的适应症中也存在。在过去5年内开始规律使用阿司匹林的使用者或使用该药预防心脏病的使用者中观察到风险降低(OR = 0.6,95% CI:0.4,1.0;OR = 0.7,95% CI:0.5,1.0)。结合先前的研究结果来看,这些结果并未提供令人信服的证据表明使用这些药物的女性卵巢癌风险真正增加。然而,它们进一步增加了总体证据的分量,这些证据总体上几乎不支持将镇痛药用作该疾病的化学预防药物。