Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48105, USA.
Cancer. 2011 Apr 15;117(8):1640-8. doi: 10.1002/cncr.25731. Epub 2010 Nov 8.
Statins and nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with reduced risk of colorectal cancer (CRC) in some studies. The objective of this study was to quantify the relative risk of inflammatory bowel disease (IBD) as a risk factor for CRC and to estimate whether this risk may be modified by long-term use of NSAIDs or statins.
The Molecular Epidemiology of Colorectal Cancer study is a population-based, case-control study of incident colorectal cancer in northern Israel and controls matched by age, sex, clinic, and ethnicity. Personal histories of IBD and medication use were measured by structured, in-person interview. The relative risk of IBD and effect modification by statins and NSAIDs were quantified by conditional and unconditional logistic regression.
Among 1921 matched pairs of CRC cases and controls, a self-reported history of IBD was associated with a 1.9-fold increased risk of CRC (95% confidence interval [CI], 1.12-3.26). Long-term statin use was associated with a reduced risk of both IBD-associated CRC (odds ratio [OR] = 0.07; 95% CI, 0.01-0.78) and non-IBD CRC (OR = 0.49; 95% CI, 0.39-0.62). Stratified analysis suggested that statins may be more protective among those with IBD (ratio of OR = 0.14; 95% CI, 0.01-1.31; P = .51), although not statistically significant. NSAID use in patients with a history of IBD was suggestive of reduced risk of CRC but did not reach statistical significance (OR = 0.47; 95% CI, 0.12-1.86).
The risk of CRC was elevated 1.9-fold in patients with IBD. Long-term statin use was associated with reduced risk of CRC in patients with IBD.
一些研究表明，他汀类药物和非甾体抗炎药（NSAIDs）可降低结直肠癌（CRC）的风险。本研究的目的是量化炎症性肠病（IBD）作为 CRC 的危险因素的相对风险，并估计这种风险是否可通过长期使用 NSAIDs 或他汀类药物来改变。
分子流行病学的大肠癌研究是基于人群的，以在以色列北部发生的结直肠癌为研究对象的病例对照研究，对照是通过年龄、性别、诊所和种族匹配的。通过结构化的面对面访谈来测量个人 IBD 病史和药物使用情况。通过条件和无条件逻辑回归来量化 IBD 的相对风险和他汀类药物和 NSAIDs 的效应修饰。
在 1921 对 CRC 病例和对照中，IBD 病史与 CRC 的风险增加 1.9 倍相关（95%置信区间 [CI]，1.12-3.26）。长期使用他汀类药物与 IBD 相关的 CRC（比值比 [OR] = 0.07；95%CI，0.01-0.78）和非 IBD CRC（OR = 0.49；95%CI，0.39-0.62）的风险降低相关。分层分析表明，他汀类药物在 IBD 患者中可能更具保护作用（OR 比值 = 0.14；95%CI，0.01-1.31；P =.51），尽管没有统计学意义。IBD 病史患者 NSAID 使用提示 CRC 风险降低，但未达到统计学意义（OR = 0.47；95%CI，0.12-1.86）。
IBD 患者的 CRC 风险增加 1.9 倍。长期使用他汀类药物与 IBD 患者的 CRC 风险降低相关。
