Vaughan Lisa E, Prizment Anna, Blair Cindy K, Thomas William, Anderson Kristin E
Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street Suite 300, Minneapolis, MN, USA.
Cancer Causes Control. 2016 Nov;27(11):1395-1402. doi: 10.1007/s10552-016-0804-8. Epub 2016 Sep 27.
Few studies have evaluated the chemopreventive effect of aspirin on the cancer risk in elderly women. We examined associations between frequency, dose, and duration of aspirin use with incidence of 719 aspirin-sensitive cancers (cancers of colon, pancreas, breast, and ovaries) in the Iowa Women's Health Study (IWHS), a prospective cohort of women over 70 years old.
Aspirin frequency, dose, and duration were self-reported in the 2004 IWHS questionnaire. Women were followed-up to 2011. Cancer cases were ascertained by linkage to the Iowa State Health Registry. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CI).
Among the 14,386 women, 30 % were nonusers of aspirin; 34 % used low-dose aspirin, and 36 % used regular- or high-dose aspirin. Compared with nonuse of aspirin, the HRs (95 % CI) for incidence of aspirin-sensitive cancers were 0.87 (0.72-1.06) for regular to high doses of aspirin use, 0.95 (0.80-1.13) for aspirin use 6+ times per week, and 0.93 (0.74-1.17) for aspirin use for 10+ years. For cumulative aspirin use, HR (95 % CI) was 0.87 (0.70-1.09) for >60,000 mg of aspirin per year and 0.95 (0.75-1.21) for >280,000 mg of aspirin in their lifetime, versus nonuse of aspirin. Results were similar for the all-cause cancer death as an endpoint, with a significant inverse association observed between lifetime aspirin dose and cancer mortality [<95,000 mg vs nonuser HR 0.76 (0.61-0.95)].
These findings suggest that aspirin use may prevent incident breast, colon, pancreatic, and ovarian cancer in elderly women.
很少有研究评估阿司匹林对老年女性癌症风险的化学预防作用。我们在爱荷华州女性健康研究（IWHS）中，调查了719例对阿司匹林敏感的癌症（结肠癌、胰腺癌、乳腺癌和卵巢癌）的发病率与阿司匹林使用频率、剂量和持续时间之间的关联，该研究是一项针对70岁以上女性的前瞻性队列研究。
阿司匹林的使用频率、剂量和持续时间在2004年IWHS问卷中由参与者自行报告。对女性随访至2011年。通过与爱荷华州健康登记处的关联来确定癌症病例。使用Cox比例风险模型来估计风险比（HRs）和95%置信区间（CI）。
在14386名女性中，30%未使用阿司匹林；34%使用低剂量阿司匹林，36%使用常规或高剂量阿司匹林。与未使用阿司匹林相比，常规至高剂量使用阿司匹林的阿司匹林敏感癌症发病率的HR（95%CI）为0.87（0.72 - 1.06），每周使用阿司匹林6次及以上的HR为0.95（0.80 - 1.13），使用阿司匹林10年及以上的HR为0.93（0.74 - 1.17）。对于累积使用阿司匹林，与未使用阿司匹林相比，每年使用超过60000毫克阿司匹林的HR（95%CI）为0.87（0.70 - 1.09），终生使用超过280000毫克阿司匹林的HR为0.95（0.75 - 1.21）。以全因癌症死亡作为终点的结果相似，在终生阿司匹林剂量与癌症死亡率之间观察到显著的负相关[<95000毫克与未使用者相比，HR为0.76（0.61 - 0.95）]。
这些发现表明，使用阿司匹林可能预防老年女性发生乳腺癌、结肠癌、胰腺癌和卵巢癌。
