Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul.
Cancer Epidemiology Branch, Research Institute, National Cancer Center, Goyang.
Ann Oncol. 2011 Nov;22(11):2456-2465. doi: 10.1093/annonc/mdq779. Epub 2011 Mar 8.
Aspirin has received increasing attention owing to its potential as a chemopreventive agent against lung cancer. Previous observational studies have reported inconsistent findings on this issue. We investigated the association between aspirin use and risk for lung cancer by conducting a meta-analysis.
Relevant studies were identified by searching Medline, EMBASE, and Cochrane Library to December 2009. We also reviewed relevant bibliographies from the retrieved articles. Two authors independently extracted data and assessed study quality. Disagreements were resolved by consensus.
Fifteen studies (six case-control studies and nine prospective cohort studies) were included in the final meta-analysis. When all studies were pooled, the odds ratio (OR) of aspirin use for lung cancer risk was 0.86 [95% confidence interval (CI) 0.76-0.98]. In subgroup meta-analyses, there was no association between aspirin use and lung cancer risk among cohort studies (relative risk, 0.97; 95% CI 0.87-1.08), while there was a significant association among case-control studies (OR, 0.74; 95% CI 0.57-0.99). In a subgroup meta-analysis by quality of study methodology, a significant protective effect of aspirin use on lung cancer was observed only among eight low-quality studies (OR, 0.82; 95% CI 0.68-0.99), but not among seven high-quality studies (OR, 0.90; 95% CI 0.76-1.07).
Overall, the findings of this meta-analysis support that there was no association between aspirin use and lung cancer risk. Our findings should be confirmed in future prospective cohort studies or randomized, controlled trials.
阿司匹林作为一种肺癌化学预防剂受到越来越多的关注。先前的观察性研究对此问题的报告结果并不一致。我们通过进行荟萃分析来研究阿司匹林的使用与肺癌风险之间的关联。
通过检索 Medline、EMBASE 和 Cochrane Library 至 2009 年 12 月,我们确定了相关的研究。我们还查阅了从检索到的文章中获取的相关文献。两位作者独立提取数据并评估研究质量。意见分歧通过协商解决。
最终的荟萃分析共纳入了 15 项研究(6 项病例对照研究和 9 项前瞻性队列研究)。当所有研究合并时,阿司匹林使用与肺癌风险的比值比(OR)为 0.86(95%置信区间[CI]0.76-0.98)。在亚组荟萃分析中,队列研究中阿司匹林的使用与肺癌风险之间没有关联(相对风险,0.97;95%CI0.87-1.08),而病例对照研究中则存在显著关联(OR,0.74;95%CI0.57-0.99)。在根据研究方法学质量进行的亚组荟萃分析中,仅在 8 项低质量研究中观察到阿司匹林使用对肺癌有显著的保护作用(OR,0.82;95%CI0.68-0.99),而在 7 项高质量研究中则没有(OR,0.90;95%CI0.76-1.07)。
总体而言,这项荟萃分析的结果支持阿司匹林的使用与肺癌风险之间没有关联。我们的发现应在未来的前瞻性队列研究或随机、对照试验中得到证实。