Lapi F, Levi M, Simonetti M, Cancian M, Parretti D, Cricelli I, Sobrero A, Cricelli C
Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy.
Department of Health Sciences, University of Florence, Florence, Italy.
Int J Cancer. 2016 Jul 1;139(1):205-11. doi: 10.1002/ijc.30061. Epub 2016 Mar 15.
A growing body of evidence indicates that use of low-dose aspirin (LDA) reduces the risk of certain adenocarcinomas. While there are several and consistent findings on the protective effect of LDA on colorectal and other cancers, few and conflicting evidence is available on prostate cancer (PCa). The aim of this study was to assess whether LDA reduces the incidence rate of PCa. We conducted a nationwide, population-based, retrospective cohort study by using Health Search IMS Health Longitudinal Patient Database (HSD). Patients with ischemic cardio- or cerebrovascular disease (index date) were identified. Time-dependent multivariable Cox proportional hazard models were adopted to estimate Hazard Ratios (HRs) and related 95% confidence intervals (95% CI) of PCa associated with use of LDA. The exposure was lagged by one year to consider the latency of drug effect on the outcome onset. Within a cohort 13,453 patients, the overall incidence rate of PCa was 2.5 per 1,000 person-years. Use of LDA was associated with a decreased incidence rate of PCa (HR = 0.64; 95% CI: 0.48-0.86), which was primarily driven by a frequency of LDA use equal to or higher than twice per week (HR = 0.60; 95% CI: 0.43-0.83). Such an association was more pronounced (HR = 0.43; 95% CI: 0.21-0.91) when LDA was used for five or more years. Our findings indicate that LDA use might be associated with a reduction of risk of PCa in patients with cardio- or cerebrovascular diseases.
越来越多的证据表明，使用低剂量阿司匹林（LDA）可降低某些腺癌的风险。虽然关于LDA对结直肠癌和其他癌症的保护作用有多项一致的研究结果，但关于前列腺癌（PCa）的证据却很少且相互矛盾。本研究的目的是评估LDA是否能降低PCa的发病率。我们使用健康搜索艾美仕健康纵向患者数据库（HSD）进行了一项全国性的、基于人群的回顾性队列研究。确定患有缺血性心血管或脑血管疾病（索引日期）的患者。采用时间依赖性多变量Cox比例风险模型来估计与使用LDA相关的PCa的风险比（HRs）和相关的95%置信区间（95%CI）。将暴露滞后一年以考虑药物对结局发生的潜伏期。在一个13453名患者的队列中，PCa的总体发病率为每1000人年2.5例。使用LDA与PCa发病率降低相关（HR = 0.64；95%CI：0.48 - 0.86），这主要是由每周使用LDA等于或高于两次的频率驱动的（HR = 0.60；95%CI：0.43 - 0.83）。当使用LDA五年或更长时间时，这种关联更为明显（HR = 0.43；95%CI：0.21 - 0.91）。我们的研究结果表明，在患有心血管或脑血管疾病的患者中，使用LDA可能与降低PCa风险有关。
