Farag Mohamed
Senior Research Fellow, Department of Cardiology, East & North Herts NHS Trust, Lister Hospital Cardiac Centre, Coreys Mill Lane , Stevenage, Hertfordshire, SG1 4AB .
J Clin Diagn Res. 2015 Jan;9(1):XE01-XE03. doi: 10.7860/JCDR/2015/9375.5391. Epub 2015 Jan 1.
Over the past few decades, the rate of cancer diagnosis has increased worldwide due to the increase in population and average life expectancy, and also, due to the advances in diagnostic medical technology that facilitate early cancer detection and recognition. Nonetheless, the treatment options have not been developed proportional to this increase, with a huge number of patients frequently being diagnosed with different types of fatal cancer. This has prompted different health organizations to search for novel strategies to prevent cancer, or even halt its progression. Having failed to provide optimum vascular protection benefits, especially with the introduction of relatively superior antiplatelets, such as adenosine diphosphate (ADP) receptor inhibitors; clopidogrel and ticagrelor, regular aspirin use was proposed to reduce the risk of common cancers like colorectal cancer, gastric cancer, breast cancer, lung cancer, prostate cancer and haematological malignancies, as suggested by epidemiological studies. However, it is difficult to draw any firm conclusions on such weak data, as this could raise false hopes among patients and physicians and could potentially mislead scientific research. Clearly, current evidence highlights a gap in medical research and emphasizes the need to carry out interventional studies in high risk for cancer patients using specific aspirin doses in order to validate the data. This should also shed some light on the risk-benefit profile in view of the potential for bleeding complications, especially with the higher doses.
在过去几十年里,由于全球人口增长、平均预期寿命延长,以及诊断医学技术进步促进了癌症的早期检测和识别,癌症诊断率有所上升。尽管如此,治疗方案的发展并未与这种增长成比例,大量患者经常被诊断出患有不同类型的致命癌症。这促使不同的卫生组织寻找预防癌症甚至阻止其进展的新策略。由于未能提供最佳的血管保护益处,尤其是在引入相对更优的抗血小板药物(如二磷酸腺苷(ADP)受体抑制剂氯吡格雷和替格瑞洛)之后,流行病学研究表明,建议定期服用阿司匹林以降低患结直肠癌、胃癌、乳腺癌、肺癌、前列腺癌和血液系统恶性肿瘤等常见癌症的风险。然而,基于如此薄弱的数据很难得出任何确凿的结论,因为这可能会在患者和医生中引发不切实际的希望,并可能误导科学研究。显然,目前的证据凸显了医学研究中的差距,并强调有必要对癌症高危患者进行干预性研究,使用特定剂量的阿司匹林以验证相关数据。鉴于出血并发症的可能性,尤其是高剂量时,这也应有助于阐明风险效益情况。