Veitonmäki Thea, Murtola Teemu J, Talala Kirsi, Taari Kimmo, Tammela Teuvo, Auvinen Anssi
Department of Urology, Tampere University Hospital, Tampere, Finland.
School of Health Sciences, University of Tampere, Tampere, Finland.
PLoS One. 2016 Apr 21;11(4):e0153413. doi: 10.1371/journal.pone.0153413. eCollection 2016.
Non-steroidal anti-inflammatory drugs (NSAIDs), especially aspirin, have been associated with lowered cancer incidence and mortality. We examined overall cancer mortality and mortality from specific cancer sites among the 80,144 men in the Finnish Prostate Cancer Screening Trial. Information on prescription drug use was acquired from the national drug reimbursement database. Over-the-counter use information was gathered by a questionnaire. Hazard ratios (HR) and 95% confidence intervals (CI) by prescription and over-the-counter NSAID use for overall and specific cancer deaths were calculated using Cox regression. During the median follow-up time of 15 years, 7,008 men died from cancer. Men with prescription NSAID use had elevated cancer mortality (HR 2.02 95% CI 1.91-2.15) compared to non-users. The mortality risk was increased for lung, colorectal and pancreas cancer mortality (HR 2.68, 95%CI 2.40-2.99, HR 1.91, 95% CI 1.57-2.32 and HR 1.93, 95% CI 1.58-2.37, respectively). The increased risk remained in competing risks regression (HR 1.11, 95% CI 1.05-1.18). When the usage during the last three years of follow-up was excluded, the effect was reversed (HR 0.69, 95% CI 0.65-0.73). Cancer mortality was not decreased for prescription or over-the-counter aspirin use. However, in the competing risk regression analysis combined prescription and over-the-counter aspirin use was associated with decreased overall cancer mortality (HR 0.76, 95% CI 0.70-0.82). Cancer mortality was increased for NSAID users. However, the risk disappeared when the last 3 years were excluded.
非甾体抗炎药（NSAIDs），尤其是阿司匹林，与癌症发病率和死亡率降低有关。我们在芬兰前列腺癌筛查试验的80144名男性中，研究了总体癌症死亡率和特定癌症部位的死亡率。处方药使用信息来自国家药品报销数据库。非处方药使用信息通过问卷调查收集。使用Cox回归计算了按处方药和非处方药NSAIDs使用情况划分的总体和特定癌症死亡的风险比（HR）及95%置信区间（CI）。在15年的中位随访期内，7008名男性死于癌症。与未使用者相比，使用处方药NSAIDs的男性癌症死亡率升高（HR 2.02，95%CI 1.91 - 2.15）。肺癌、结直肠癌和胰腺癌死亡率的死亡风险增加（分别为HR 2.68，95%CI 2.40 - 2.99；HR 1.91，95%CI 1.57 - 2.32；HR 1.93，95%CI 1.58 - 2.37）。在竞争风险回归中，增加的风险仍然存在（HR 1.11，95%CI 1.05 - 1.18）。当排除随访最后三年的使用情况时，效果逆转（HR 0.69，95%CI 0.65 - 0.73）。处方药或非处方药阿司匹林的使用并未降低癌症死亡率。然而，在竞争风险回归分析中，处方药和非处方药联合使用阿司匹林与总体癌症死亡率降低有关（HR 0.76，95%CI 0.70 - 0.82）。NSAIDs使用者的癌症死亡率增加。然而，当排除最后3年时，风险消失。
