Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland, USA.
Cancer Prev Res (Phila). 2011 Dec;4(12):2027-34. doi: 10.1158/1940-6207.CAPR-11-0274. Epub 2011 Sep 1.
Several case-control studies have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs) reduce risk for glioblastoma, an aggressive form of brain cancer. Prospective investigations have not observed such an association, but these studies lacked adequate brain cancer case numbers and did not stratify by histologic subtype. We prospectively investigated the association between NSAID use and risk of all glioma as well as the risk of glioblastoma subtype in the National Institutes of Health (NIH)-AARP Diet and Health Study. The frequency of aspirin and nonaspirin NSAID use 1 year prior to baseline was ascertained using a self-administered questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using Cox regression models with age as the underlying time metric, adjusted for sex, race, and history of heart disease. The analysis included 302,767 individuals, with 341 incident glioma cases (264 glioblastoma). No association was observed between regular use (>2 times/wk) of aspirin and risk of glioma (HR = 1.16; 95% CI, 0.87-1.56) or glioblastoma (HR = 1.17; 95% CI, 0.83-1.64) as compared with no use. Null associations were also observed for nonaspirin NSAID use (HR for glioma = 0.90; 95% CI, 0.65-1.25 and HR for glioblastoma = 0.83; 95% CI, 0.56-1.20) as compared with no use. Our findings from this large prospective study do not support an inverse association between NSAIDs and risk of all glioma or glioblastoma.
几项病例对照研究表明，非甾体抗炎药（NSAIDs）可降低胶质母细胞瘤（一种侵袭性脑癌）的风险。前瞻性研究并未观察到这种关联，但这些研究缺乏足够的脑癌病例数量，并且没有按组织学亚型进行分层。我们前瞻性地研究了 NSAID 使用与所有胶质瘤风险以及 NIH-AARP 饮食与健康研究中胶质母细胞瘤亚型风险之间的关联。使用自我管理问卷确定了基线前 1 年使用阿司匹林和非阿司匹林 NSAID 的频率。使用 Cox 回归模型估计风险比（HR）和 95％置信区间（CI），年龄为基础时间度量，调整了性别，种族和心脏病史。该分析包括 302767 人，有 341 例新发胶质瘤病例（264 例胶质母细胞瘤）。与不使用相比，定期（> 2 次/周）使用阿司匹林与胶质瘤（HR = 1.16；95％CI，0.87-1.56）或胶质母细胞瘤（HR = 1.17；95％CI，0.83-1.64）风险之间没有关联。与不使用相比，非阿司匹林 NSAID 的使用也观察到了零关联（胶质瘤的 HR = 0.90；95％CI，0.65-1.25和胶质母细胞瘤的 HR = 0.83；95％CI，0.56-1.20）。我们从这项大型前瞻性研究中得出的发现不支持 NSAIDs 与所有胶质瘤或胶质母细胞瘤风险之间存在反比关联。
