阿司匹林使用与胰腺癌风险的病例对照研究。
Case-control study of aspirin use and risk of pancreatic cancer.
作者信息
Streicher Samantha A, Yu Herbert, Lu Lingeng, Kidd Mark S, Risch Harvey A
机构信息
Authors' Affiliations: Department of Chronic Disease Epidemiology, Yale School of Public Health;
Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
出版信息
Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1254-63. doi: 10.1158/1055-9965.EPI-13-1284.
BACKGROUND
Pancreas-cancer prognosis is dismal, with 5-year survival less than 5%. Significant relationships between aspirin use and decreased pancreas-cancer incidence and mortality have been shown in four of 13 studies.
METHODS
To evaluate further a possible association between aspirin use and risk of pancreatic cancer, we used data from a population-based Connecticut study conducted from January 2005 to August 2009, of 362 pancreas-cancer cases frequency matched to 690 randomly sampled controls.
RESULTS
Overall, regular use of aspirin was associated with reduced risk of pancreatic cancer [odds ratio (OR), 0.52; 95% confidence interval (CI), 0.39-0.69]. Increments of decreasing risk of pancreatic cancer were observed for each year of low-dose or regular-dose aspirin use (OR, 0.94; 95% CI, 0.91-0.98 and OR, 0.98; 95% CI, 0.96-1.01, respectively) and for increasing years in the past that low-dose or regular-dose aspirin use had started (OR, 0.95; 95% CI, 0.92-0.99 and OR, 0.98; 95% CI, 0.96-1.00, respectively). Reduced risk of pancreatic cancer was seen in most categories of calendar time period of aspirin use, for both low-dose aspirin and regular-dose aspirin use. Relative to continuing use at the time of interview, termination of aspirin use within 2 years of interview was associated with increased risk of pancreatic cancer (OR, 3.24; 95% CI, 1.58-6.65).
CONCLUSIONS
Our results provide some support that a daily aspirin regimen may reduce risk of developing pancreatic cancer.
IMPACT
Long-term aspirin use has benefits for both cardiovascular disease and cancer, but appreciable bleeding complications that necessitate risk-benefit analysis for individual applications.
背景
胰腺癌的预后很差，5年生存率低于5%。在13项研究中的4项研究中，已表明阿司匹林的使用与胰腺癌发病率和死亡率的降低之间存在显著关系。
方法
为了进一步评估阿司匹林的使用与胰腺癌风险之间可能存在的关联，我们使用了来自康涅狄格州一项基于人群的研究数据，该研究于2005年1月至2009年8月进行，对362例胰腺癌病例进行了频率匹配，与690例随机抽样的对照进行比较。
结果
总体而言，定期使用阿司匹林与胰腺癌风险降低相关[比值比（OR），0.52；95%置信区间（CI），0.39 - 0.69]。低剂量或常规剂量阿司匹林使用的每一年，胰腺癌风险降低的幅度均被观察到（OR分别为0.94；95%CI，0.91 - 0.98和OR，0.98；95%CI，0.96 - 1.01），以及过去开始低剂量或常规剂量阿司匹林使用的年限增加时（OR分别为0.95；95%CI，0.92 - 0.99和OR，0.98；95%CI，0.96 - 1.00）。在阿司匹林使用的大多数日历时间段类别中，无论是低剂量阿司匹林还是常规剂量阿司匹林的使用，都观察到胰腺癌风险降低。相对于在访谈时持续使用，在访谈后2年内停止使用阿司匹林与胰腺癌风险增加相关（OR，3.24；95%CI，1.58 - 6.65）。
结论
我们的结果提供了一些支持，即每日服用阿司匹林方案可能降低患胰腺癌的风险。
影响
长期使用阿司匹林对心血管疾病和癌症都有益处，但存在明显的出血并发症，因此需要对个体应用进行风险效益分析。
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