Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
CESP "Health Across Generations", INSERM, Univ Paris-Sud, UVSQ, Univ Paris-Saclay, Villejuif, France.
Int J Cancer. 2018 Oct 1;143(7):1688-1695. doi: 10.1002/ijc.31570. Epub 2018 Jul 24.
Experimental studies have shown a protective effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on breast cancer development. However, results from epidemiological cohort studies are less consistent. Our objective was to assess the association between NSAID use and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Self-reported information on NSAID use at baseline has been collected in five EPIC countries. Multivariable Cox regression models were used to estimate hazard ratios for the association of NSAID use with breast cancer incidence with adjustment for potential confounders. We also assessed effect modification by breast cancer risk factors and examined the associations within specific breast cancer subtypes. Among the 140,981 women included in the analysis, 7% were regularly using NSAIDs at baseline. During a median follow-up time period of 13 years, 7,379 incident breast cancer cases were diagnosed (816 in situ and 6,563 invasive). There were no statistically significant associations between NSAID use and breast cancer risk, overall and by subtypes. However, a statistically significant interaction was observed for invasive cases between NSAID use and ever use of menopausal hormonal therapy (MHT) among postmenopausal women [MHT users: HR = 0.84 (0.73-0.96); non MHT users: HR = 1.08 (0.93-1.25); p = 0.05]. Our results indicate potential effect modification of MHT use on the association between use of NSAIDs and breast cancer risk which deserves in-depth investigation in studies with accurate data on both NSAID and MHT use.
实验研究表明，非甾体抗炎药（NSAIDs）对乳腺癌的发展具有保护作用。然而，来自流行病学队列研究的结果则不太一致。我们的目的是评估欧洲癌症与营养前瞻性调查（EPIC）中 NSAID 使用与乳腺癌风险之间的关联。EPIC 是一项于 1992 年在 10 个欧洲国家启动的前瞻性队列研究。在五个 EPIC 国家，在基线时收集了关于 NSAID 使用情况的自我报告信息。使用多变量 Cox 回归模型来估计 NSAID 使用与乳腺癌发病率之间的关联的风险比，并调整了潜在的混杂因素。我们还评估了乳腺癌危险因素的效应修饰作用，并在特定的乳腺癌亚型内进行了相关性研究。在分析中包括的 140981 名女性中，有 7%在基线时经常使用 NSAIDs。在中位随访时间为 13 年期间，诊断出 7379 例乳腺癌新发病例（816 例原位癌和 6563 例浸润性癌）。总体而言，以及根据亚型进行分类时，NSAID 使用与乳腺癌风险之间没有统计学上的显著关联。然而，在绝经后妇女中，NSAID 使用与绝经后激素治疗（MHT）的使用之间，观察到浸润性病例之间存在统计学显著的交互作用（MHT 使用者：HR=0.84（0.73-0.96）；非 MHT 使用者：HR=1.08（0.93-1.25）；p=0.05）。我们的结果表明，MHT 使用对 NSAID 使用与乳腺癌风险之间的关联存在潜在的效应修饰作用，这需要在具有 NSAID 和 MHT 使用准确数据的研究中进行深入调查。
