Lin C C, Lai M S, Shau W Y
Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei.
Diabet Med. 2015 Mar;32(3):324-31. doi: 10.1111/dme.12596. Epub 2014 Nov 14.
To evaluate whether aspirin can reduce the risk of colorectal cancer in people with diabetes.
We studied ≥ 30-year-old people with diabetes, included in the Longitudinal Health Insurance Database 2005 in Taiwan, who were treated with hypoglycaemic drugs. We used a time-varying Cox regression model to adjust for immortal time bias and to estimate the adjusted hazard ratio and 95% CI for the association between aspirin use and colorectal cancer occurrence.
We studied a total of 60 828 people with diabetes (31 176 men and 29 652 women). Their mean (sd) age was 58.72 (13.33) years. A total of 26 494 people were taking aspirin. Aspirin use 3-5 times/week (moderate frequency) for > 5 years (long duration) was found to reduce the risk of colorectal cancer by 46% (hazard ratio 0.54, 95% CI 0.34-0.86). Aspirin use > 5 times/week (high frequency) for 4-5 years (moderate duration) and > 5 years reduced the risk of colorectal cancer by 56 and 68%, respectively (hazard ratio 0.44, 95% CI 0.24-0.80; hazard ratio 0.32, 95% CI 0.20-0.50). Low frequency (≤ 2 times/week) and/or short duration (≤ 3 years) of aspirin use did not reduce the risk of colorectal cancer.
Aspirin use with high frequency and long duration reduced the risk of colorectal cancer in people with diabetes in a frequency- and duration-dependent manner, whereas low frequency and/or short duration of aspirin use did not. The dosage, frequency and duration of aspirin use that are sufficient to prevent the incidence of colorectal cancer in people with diabetes require further study.
评估阿司匹林是否能降低糖尿病患者患结直肠癌的风险。
我们研究了台湾2005年纵向健康保险数据库中年龄≥30岁、接受降糖药物治疗的糖尿病患者。我们使用时变Cox回归模型来校正不朽时间偏倚，并估计阿司匹林使用与结直肠癌发生之间关联的校正风险比和95%置信区间。
我们共研究了60828名糖尿病患者（男性31176名，女性29652名）。他们的平均（标准差）年龄为58.72（13.33）岁。共有26494人服用阿司匹林。发现每周服用3 - 5次（中等频率）且服用时间超过5年（长时间）可使结直肠癌风险降低46%（风险比0.54，95%置信区间0.34 - 0.86）。每周服用超过5次（高频率）且服用4 - 5年（中等时间）和超过5年分别可使结直肠癌风险降低56%和68%（风险比0.44，95%置信区间0.24 - 0.80；风险比0.32，95%置信区间0.20 - 0.50）。低频率（每周≤2次）和/或短时间（≤3年）使用阿司匹林并不能降低结直肠癌风险。
高频率和长时间使用阿司匹林以频率和时间依赖的方式降低了糖尿病患者患结直肠癌的风险，而低频率和/或短时间使用则不然。足以预防糖尿病患者结直肠癌发病的阿司匹林使用剂量、频率和时间需要进一步研究。
