经常使用阿司匹林和其他非甾体抗炎药与家族性或遗传性乳腺癌风险的女性：队列研究。
Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk: a cohort study.
机构信息
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA.
Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, 3010, Australia.
出版信息
Breast Cancer Res. 2019 Apr 18;21(1):52. doi: 10.1186/s13058-019-1135-y.
BACKGROUND
The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced breast cancer risk, but it is not known if this association extends to women at familial or genetic risk. We examined the association between regular NSAID use and breast cancer risk using a large cohort of women selected for breast cancer family history, including 1054 BRCA1 or BRCA2 mutation carriers.
METHODS
We analyzed a prospective cohort (N = 5606) and a larger combined, retrospective and prospective, cohort (N = 8233) of women who were aged 18 to 79 years, enrolled before June 30, 2011, with follow-up questionnaire data on medication history. The prospective cohort was further restricted to women without breast cancer when medication history was asked by questionnaire. Women were recruited from seven study centers in the United States, Canada, and Australia. Associations were estimated using multivariable Cox proportional hazards regression models adjusted for demographics, lifestyle factors, family history, and other medication use. Women were classified as regular or non-regular users of aspirin, COX-2 inhibitors, ibuprofen and other NSAIDs, and acetaminophen (control) based on self-report at follow-up of ever using the medication for at least twice a week for ≥1 month prior to breast cancer diagnosis. The main outcome was incident invasive breast cancer, based on self- or relative-report (81% confirmed pathologically).
RESULTS
From fully adjusted analyses, regular aspirin use was associated with a 39% and 37% reduced risk of breast cancer in the prospective (HR = 0.61; 95% CI = 0.33-1.14) and combined cohorts (HR = 0.63; 95% CI = 0.57-0.71), respectively. Regular use of COX-2 inhibitors was associated with a 61% and 71% reduced risk of breast cancer (prospective HR = 0.39; 95% CI = 0.15-0.97; combined HR = 0.29; 95% CI = 0.23-0.38). Other NSAIDs and acetaminophen were not associated with breast cancer risk in either cohort. Associations were not modified by familial risk, and consistent patterns were found by BRCA1 and BRCA2 carrier status, estrogen receptor status, and attained age.
CONCLUSION
Regular use of aspirin and COX-2 inhibitors might reduce breast cancer risk for women at familial or genetic risk.
背景
阿司匹林和其他非甾体抗炎药（NSAIDs）的使用与降低乳腺癌风险有关，但尚不清楚这种关联是否适用于有家族史或遗传风险的女性。我们使用包括 1054 名 BRCA1 或 BRCA2 突变携带者在内的大型乳腺癌家族史女性队列，研究了定期使用 NSAID 与乳腺癌风险之间的关系。
方法
我们分析了一个前瞻性队列（N=5606）和一个更大的、回顾性和前瞻性相结合的队列（N=8233），这些女性年龄在 18 至 79 岁之间，于 2011 年 6 月 30 日前入组，并在随访时通过问卷调查获取用药史数据。前瞻性队列进一步限制为在询问用药史时没有乳腺癌的女性。这些女性来自美国、加拿大和澳大利亚的七个研究中心。使用多变量 Cox 比例风险回归模型估计关联，该模型调整了人口统计学、生活方式因素、家族史和其他药物使用情况。根据随访时的自我报告，将女性分为阿司匹林、COX-2 抑制剂、布洛芬和其他 NSAIDs 以及醋氨酚（对照）的定期使用者或非定期使用者，标准为至少每周两次、每次至少 1 个月，用于在乳腺癌诊断前预防疾病。主要结局是浸润性乳腺癌的发病情况，基于自我报告或亲属报告（81%经病理证实）。
结果
在完全调整的分析中，前瞻性队列中定期使用阿司匹林与乳腺癌风险降低 39%（HR=0.61；95%CI=0.33-1.14）和联合队列中降低 37%（HR=0.63；95%CI=0.57-0.71）相关。定期使用 COX-2 抑制剂与乳腺癌风险降低 61%（前瞻性 HR=0.39；95%CI=0.15-0.97）和 71%（联合 HR=0.29；95%CI=0.23-0.38）相关。在两个队列中，其他 NSAIDs 和醋氨酚与乳腺癌风险均无关。家族风险并未改变这种关联，BRCA1 和 BRCA2 携带者状态、雌激素受体状态和达到的年龄也存在一致的模式。
结论
定期使用阿司匹林和 COX-2 抑制剂可能会降低有家族史或遗传风险的女性的乳腺癌风险。
Zotero 插件