Department of Urology Surgery, The Second Clinical College, Harbin Medical University, Harbin, Heilongjiang Province, China.
PLoS One. 2013 Jul 19;8(7):e70008. doi: 10.1371/journal.pone.0070008. Print 2013.
Several epidemiologic studies have evaluated the association between nonsteroidal anti-inflammatory drugs (NSAIDs) and bladder cancer risk and the results were varied. Thus, we conducted a comprehensive meta-analysis of studies exclusively dedicated to the relationship between the 3 most commonly used analgesics and bladder cancer risk.
A systematic literature search up to November 2012 was performed in PubMed database for 3 categories of analgesics: acetaminophen, aspirin or non-aspirin NSAIDs. Study-specific risk estimates were pooled using a random-effects model.
Seventeen studies (8 cohort and 9 case-control studies), involving a total of 10,618 bladder cancer cases, were contributed to the analysis. We found that acetaminophen (relative risk [RR] 1.01, 95% confidence interval [CI] 0.88-1.17) and aspirin (RR 1.02, 95% CI 0.91-1.14) were not associated with bladder cancer risk. Although non-aspirin NSAIDs was statistically significantly associated with reduced risk of bladder cancer among case-control studies (but not cohort studies), the overall risk was not statistically significant (RR 0.87, 95% CI 0.73-1.05). Furthermore, we also found that non-aspirin NSAIDs use was significantly associated with a 43% reduction in bladder cancer risk among nonsmokers (RR 0.57, 95% CI 0.43-0.76), but not among current smokers.
The results of our meta-analysis suggest that there is no association between use of acetaminophen, aspirin or non-aspirin NSAIDs and bladder cancer risk. However, non-aspirin NSAIDs use might be associated with a reduction in risk of bladder cancer for nonsmokers.
几项流行病学研究评估了非甾体抗炎药（NSAIDs）与膀胱癌风险之间的关系，结果各不相同。因此，我们对专门研究 3 种最常用镇痛药与膀胱癌风险之间关系的研究进行了综合荟萃分析。
我们在 PubMed 数据库中进行了系统的文献检索，检索时间截至 2012 年 11 月，检索内容涵盖 3 类镇痛药：对乙酰氨基酚、阿司匹林或非阿司匹林类 NSAIDs。使用随机效应模型汇总研究特异性风险估计值。
共有 17 项研究（8 项队列研究和 9 项病例对照研究），共纳入 10618 例膀胱癌病例，纳入分析。我们发现，对乙酰氨基酚（相对风险 [RR] 1.01，95%置信区间 [CI] 0.88-1.17）和阿司匹林（RR 1.02，95% CI 0.91-1.14）与膀胱癌风险无关。尽管非阿司匹林类 NSAIDs 与病例对照研究中膀胱癌风险降低呈统计学显著相关（但与队列研究无关），但总体风险无统计学意义（RR 0.87，95% CI 0.73-1.05）。此外，我们还发现，非阿司匹林类 NSAIDs 的使用与非吸烟者膀胱癌风险降低 43%相关（RR 0.57，95% CI 0.43-0.76），但与吸烟者无关。
我们的荟萃分析结果表明，使用对乙酰氨基酚、阿司匹林或非阿司匹林类 NSAIDs 与膀胱癌风险之间无关联。然而，非阿司匹林类 NSAIDs 的使用可能与非吸烟者膀胱癌风险降低有关。
