Yang Yi-Sun, Kornelius Edy, Chiou Jeng-Yuan, Lai Yung-Rung, Lo Shih-Chang, Peng Chiung-Huei, Huang Chien-Ning
1 Institute of Medicine, School of Medicine, Chung Shan Medical University , Taichung, Taiwan .
2 Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital , Taichung, Taiwan .
J Womens Health (Larchmt). 2017 Dec;26(12):1278-1284. doi: 10.1089/jwh.2016.6040. Epub 2017 May 24.
Low-dose aspirin is commonly used for preventing cardiovascular disease in people with diabetes, but its association with cancer remains controversial. This study used a nationwide population-based reimbursement database to investigate the relationship between low-dose aspirin use and breast cancer incidence in women with diabetes.
This retrospective cohort study was conducted using data retrieved from the National Health Insurance Research Database in Taiwan from January 1, 1998 to December 31, 2011. Women diagnosed as having diabetes with low-dose aspirin use (75-165 mg daily) were identified as the study population, whereas those without low-dose aspirin use were selected as the comparison group.
We analyzed 148,739 patients with diabetes. Their mean age (standard deviation) was 63.3 (12.8) years. A total of 27,378 patients were taking aspirin. Overall, the use of aspirin in patients with diabetes reduced the risk of breast cancer by 18% (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.71-0.94) after adjustment for potential confounders, namely age and comorbidities. Specifically, a cumulative dose of aspirin exceeding 88,900 mg was observed to reduce the risk of breast cancer by 47% (HR, 0.53, 95% CI, 0.43-0.67); however, low (<8,600 mg) and medium (8,600-88,900 mg) cumulative doses of aspirin did not reduce the risk of breast cancer.
Our findings suggest that a cumulative aspirin dosage of more than 88,900 mg daily was associated with a reduced risk of breast cancer in women with diabetes. However, additional studies are necessary to confirm these findings.
低剂量阿司匹林常用于预防糖尿病患者的心血管疾病，但其与癌症的关联仍存在争议。本研究利用全国性的基于人群的报销数据库，调查低剂量阿司匹林使用与糖尿病女性乳腺癌发病率之间的关系。
这项回顾性队列研究使用了从1998年1月1日至2011年12月31日台湾国民健康保险研究数据库中检索的数据。被诊断为使用低剂量阿司匹林（每日75 - 165毫克）的糖尿病女性被确定为研究人群，而未使用低剂量阿司匹林的女性被选为对照组。
我们分析了148,739例糖尿病患者。他们的平均年龄（标准差）为63.3（12.8）岁。共有27,378例患者服用阿司匹林。总体而言，在调整潜在混杂因素（即年龄和合并症）后，糖尿病患者使用阿司匹林可使乳腺癌风险降低18%（风险比[HR]，0.82；95%置信区间[CI]，0.71 - 0.94）。具体而言，观察到阿司匹林累积剂量超过88,900毫克可使乳腺癌风险降低47%（HR，0.53，95% CI，0.43 - 0.67）；然而，低（<8,600毫克）和中等（8,600 - 88,900毫克）累积剂量的阿司匹林并未降低乳腺癌风险。
我们的研究结果表明，每日阿司匹林累积剂量超过88,900毫克与糖尿病女性乳腺癌风险降低有关。然而，需要进一步的研究来证实这些发现。
