Baik Christina S, Brasky Theodore M, Pettinger Mary, Luo Juhua, Gong Zhihong, Wactawski-Wende Jean, Prentice Ross L
Department of Medicine, University of Washington, Seattle, Washington.
The Ohio State University College of Medicine, Columbus, Ohio.
Cancer Epidemiol Biomarkers Prev. 2015 May;24(5):790-7. doi: 10.1158/1055-9965.EPI-14-1322. Epub 2015 Feb 10.
Results from prospective studies suggest that nonsteroidal anti-inflammatory drugs (NSAID) may decrease lung cancer risk; however, any protective effect appears to be most evident in men.
We evaluated the associations between NSAID use and lung cancer incidence in postmenopausal women in the Women's Health Initiative (WHI) adjusting for female-specific potential confounders such as hormone therapy in addition to smoking histories and other potential confounders. We identified 143,841 women from ages 50 to 79 and 1,902 centrally confirmed lung cancer cases were included in the analysis. We used Cox regression models to estimate HRs and their 95% confidence intervals (CI).
Compared with nonuse, regular NSAID use was not associated with overall lung cancer incidence (NSAID use >10 years HR 0.87; 95% CI, 0.71-1.08, P(trend) = 0.13). No statistically significant associations were found when examined by histologic subtypes and although there was a trend of decreased risk with longer duration of NSAID use in the adenocarcinoma subtype, this was not statistically significant (NSAID use >10 years HR 0.80; 95% CI, 0.58-1.10; P(trend) = 0.07).
Our study did not show that NSAID use is associated with lung cancer risk in women even after adjusting for female-specific confounders. There was a trend of decreased risk in the adenocarcinoma subtype; however, this was not statistically significant.
Future studies will need to take in account the various molecular subtypes of non-small cell lung cancer to further elucidate the role of NSAIDs in lung cancer, especially for the adenocarcinoma subtype.
前瞻性研究结果表明，非甾体抗炎药（NSAID）可能降低肺癌风险；然而，任何保护作用似乎在男性中最为明显。
我们在女性健康倡议（WHI）中评估了绝经后女性使用NSAID与肺癌发病率之间的关联，除吸烟史和其他潜在混杂因素外，还对激素治疗等女性特异性潜在混杂因素进行了校正。我们从143,841名年龄在50至79岁的女性中进行了筛选，1902例经中心确认的肺癌病例纳入分析。我们使用Cox回归模型来估计风险比（HR）及其95%置信区间（CI）。
与未使用NSAID相比，规律使用NSAID与总体肺癌发病率无关（使用NSAID>10年，HR为0.87；95%CI为0.71-1.08，P（趋势）=0.13）。按组织学亚型检查时未发现统计学上的显著关联，尽管在腺癌亚型中，随着NSAID使用时间延长有风险降低的趋势，但这在统计学上并不显著（使用NSAID>10年，HR为0.80；95%CI为0.58-1.10；P（趋势）=0.07）。
我们的研究表明，即使在对女性特异性混杂因素进行校正后，使用NSAID与女性肺癌风险无关。腺癌亚型有风险降低的趋势；然而，这在统计学上并不显著。
未来的研究需要考虑非小细胞肺癌的各种分子亚型，以进一步阐明NSAIDs在肺癌中的作用，特别是对于腺癌亚型。
