Park Song-Yi, Wilkens Lynne R, Kolonel Laurence N, Monroe Kristine R, Haiman Christopher A, Marchand Loïc Le
Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
Office of Public Health Studies, University of Hawaii, Honolulu, Hawaii.
Cancer Epidemiol Biomarkers Prev. 2017 Feb;26(2):162-169. doi: 10.1158/1055-9965.EPI-16-0560. Epub 2016 Oct 10.
Evidence has accumulated that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protects against colorectal cancer. We tested whether the inverse associations between NSAIDs and colorectal cancer is similarly observed across sexes and five racial/ethnic groups (Japanese, Latino, African American, Native Hawaiian, and white) in the Multiethnic Cohort (MEC) Study.
During a mean follow-up of 16.1 years, we identified 4,882 invasive incident colorectal cancer cases among 183,199 eligible participants. Cox proportional hazards models were used to calculate HRs and 95% confidence intervals (CI).
Use of aspirin and other NSAIDs was associated with a lower incidence of colorectal cancer in men (HR = 0.77; 95% CI, 0.69-0.86 for current vs. never users of aspirin) but not in women (P = 0.005). Among male current users, a reduced risk was observed with ≥6 years of aspirin or total NSAID use. The inverse association with current NSAID use in men was observed in all racial/ethnic groups, except for Native Hawaiians, and was stronger in whites.
Our findings suggest that the benefit of NSAIDs for colorectal cancer may be strongest for white men and generalizes to African American, Japanese, and Latino, but not to Native Hawaiian men. The lack of inverse association observed in women and Native Hawaiian men in the MEC should be interpreted with caution.
As only very few ethnic/racial groups are likely to be represented in trials of NSAIDs and colorectal cancer, it is important to conduct prospective observational studies in various populations to test the generalizability of their results. Cancer Epidemiol Biomarkers Prev; 26(2); 162-9. ©2016 AACR.
越来越多的证据表明，长期使用阿司匹林和其他非甾体抗炎药（NSAIDs）可预防结直肠癌。在多民族队列（MEC）研究中，我们测试了NSAIDs与结直肠癌之间的反向关联是否在不同性别和五个种族/族裔群体（日本人、拉丁裔、非裔美国人、夏威夷原住民和白人）中同样存在。
在平均16.1年的随访期间，我们在183,199名符合条件的参与者中确定了4,882例浸润性结直肠癌病例。使用Cox比例风险模型计算风险比（HRs）和95%置信区间（CI）。
使用阿司匹林和其他NSAIDs与男性结直肠癌发病率较低相关（HR = 0.77；当前使用阿司匹林与从未使用者相比，95%CI为0.69 - 0.86），但与女性无关（P = 0.005）。在男性当前使用者中，阿司匹林或总NSAIDs使用≥6年可观察到风险降低。除夏威夷原住民外，在所有种族/族裔群体的男性中均观察到当前使用NSAIDs与结直肠癌之间的反向关联，且在白人中更强。
我们的研究结果表明，NSAIDs对结直肠癌的益处可能对白人男性最强，并推广到非裔美国人、日本人及拉丁裔，但不适用于夏威夷原住民男性。在MEC研究中女性和夏威夷原住民男性未观察到反向关联，对此应谨慎解释。
由于NSAIDs与结直肠癌试验中可能仅代表极少数种族/族裔群体，因此在不同人群中进行前瞻性观察性研究以测试其结果的普遍性非常重要。《癌症流行病学、生物标志物与预防》；26(2)；162 - 169。©2016美国癌症研究协会。
