Danforth Kim N, Gierach Gretchen L, Brinton Louise A, Hollenbeck Albert R, Katki Hormuzd A, Leitzmann Michael F, Schatzkin Arthur, Lacey James V
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health/DHHS, 6120 Executive Boulevard, Rockville, MD 20852, USA.
Cancer Prev Res (Phila). 2009 May;2(5):466-72. doi: 10.1158/1940-6207.CAPR-08-0239. Epub 2009 Apr 28.
Chronic inflammation may play an etiologic role in endometrial cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammatory activity by inhibiting the proinflammatory cyclooxygenase enzymes and, therefore, may decrease cancer risk. However, few studies have examined the association between NSAID use and endometrial cancer. We conducted a prospective study among 72,524 women in the NIH-AARP Diet and Health Study. Women completed a questionnaire in 1996-1997 on lifestyle and health-related factors, including type and frequency of NSAID use within the past year, and were followed through 2003 by linkages to cancer registries and vital status databases. During 488,261 person-years of follow-up, there were 732 incident endometrial cancers. NSAID use, compared with nonuse of NSAIDs, was not significantly associated with endometrial cancer risk [relative risk (RR), 0.90; 95% confidence interval (95% CI), 0.74-1.09]. Null associations were also observed by type of NSAID use [aspirin only: RR, 0.88; 95% CI, 0.70-1.11; nonaspirin NSAID (NA-NSAID) only: RR, 1.01; 95% CI, 0.79-1.29; both aspirin and NA-NSAIDs: RR, 0.85; 95% CI, 0.68-1.06]. Generally, results were not statistically significant by frequency of use for aspirin or NA-NSAIDs. Results did not change when women with a history of heart disease, hypertension, or diabetes were excluded to minimize the potential for confounding by indication. Overall, our data do not support an association between aspirin or NA-NSAID use and endometrial cancer risk.
慢性炎症可能在子宫内膜癌的病因学中发挥作用。非甾体抗炎药（NSAIDs）通过抑制促炎环氧化酶来降低炎症活性，因此可能降低癌症风险。然而，很少有研究探讨NSAIDs使用与子宫内膜癌之间的关联。我们在美国国立卫生研究院-美国退休人员协会饮食与健康研究中的72524名女性中进行了一项前瞻性研究。女性在1996 - 1997年完成了一份关于生活方式和健康相关因素的问卷，包括过去一年中NSAIDs的使用类型和频率，并通过与癌症登记处和生命状况数据库的关联追踪至2003年。在488261人年的随访期间，有732例新发子宫内膜癌。与未使用NSAIDs相比，使用NSAIDs与子宫内膜癌风险无显著关联[相对风险（RR），0.90；95%置信区间（95%CI），0.74 - 1.09]。按NSAIDs使用类型观察到的关联也为无效[仅使用阿司匹林：RR，0.88；95%CI，0.70 - 1.11；仅使用非阿司匹林NSAID（NA - NSAID）：RR，1.01；95%CI，0.79 - 1.29；同时使用阿司匹林和NA - NSAIDs：RR，0.85；95%CI，0.68 - 1.06]。一般来说，阿司匹林或NA - NSAIDs的使用频率方面的结果无统计学意义。当排除有心脏病、高血压或糖尿病病史的女性以尽量减少指征性混杂的可能性时，结果没有改变。总体而言，我们的数据不支持使用阿司匹林或NA - NSAID与子宫内膜癌风险之间存在关联。
