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护士健康研究II中绝经前女性使用阿司匹林、其他非甾体抗炎药和对乙酰氨基酚与患乳腺癌风险的关系

Use of aspirin, other nonsteroidal anti-inflammatory drugs, and acetaminophen and risk of breast cancer among premenopausal women in the Nurses' Health Study II.

作者信息

Eliassen A Heather, Chen Wendy Y, Spiegelman Donna, Willett Walter C, Hunter David J, Hankinson Susan E

机构信息

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA.

出版信息

Arch Intern Med. 2009 Jan 26;169(2):115-21; discussion 121. doi: 10.1001/archinternmed.2008.537.

Abstract

BACKGROUND

The use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) is widespread for treatment of common symptoms such as headaches, muscular pain, and inflammation. In addition, the chemopreventive use of NSAIDs is increasingly common for heart disease and colon cancer. Evidence of a protective association with breast cancer risk has been inconsistent, and few data exist for premenopausal women.

METHODS

We assessed the associations for use of aspirin, other NSAIDs, and acetaminophen with breast cancer risk among premenopausal women in the prospective Nurses' Health Study II. In total, 112,292 women, aged 25 to 42 years and free of cancer in 1989, were followed up until June 2003. Multivariate relative risks and 95% confidence intervals were calculated by Cox proportional hazards models, adjusting for age and other important breast cancer risk factors.

RESULTS

Overall, 1345 cases of invasive premenopausal breast cancer were documented. Regular use of aspirin (> or = 2 times per week) was not significantly associated with breast cancer risk (relative risk, 1.07; 95% confidence interval, 0.89-1.29). Regular use of either nonaspirin NSAIDs or acetaminophen also was not consistently associated with breast cancer risk. Results did not vary by frequency (days per week), dose (tablets per week), or duration of use. Furthermore, associations with each drug category did not vary substantially by estrogen and progesterone receptor status of the tumor.

CONCLUSION

These data suggest that the use of aspirin, other NSAIDs, and acetaminophen is not associated with a reduced risk of breast cancer among premenopausal women.

摘要

背景

阿司匹林和其他非甾体抗炎药(NSAIDs)广泛用于治疗头痛、肌肉疼痛和炎症等常见症状。此外,NSAIDs在心脏病和结肠癌的化学预防应用中越来越普遍。与乳腺癌风险存在保护关联的证据并不一致,且关于绝经前女性的数据很少。

方法

在前瞻性护士健康研究II中,我们评估了阿司匹林、其他NSAIDs和对乙酰氨基酚的使用与绝经前女性乳腺癌风险之间的关联。共有112292名年龄在25至42岁之间且在1989年无癌症的女性,随访至2003年6月。通过Cox比例风险模型计算多变量相对风险和95%置信区间,并对年龄和其他重要的乳腺癌风险因素进行调整。

结果

总体而言,记录了1345例绝经前浸润性乳腺癌病例。定期使用阿司匹林(每周≥2次)与乳腺癌风险无显著关联(相对风险为1.07;95%置信区间为0.89 - 1.29)。定期使用非阿司匹林NSAIDs或对乙酰氨基酚也与乳腺癌风险无一致关联。结果在使用频率(每周天数)、剂量(每周片数)或使用时长方面并无差异。此外,每种药物类别与肿瘤雌激素和孕激素受体状态之间的关联也无显著差异。

结论

这些数据表明,在绝经前女性中,使用阿司匹林、其他NSAIDs和对乙酰氨基酚与降低乳腺癌风险无关。

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