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使用他汀类药物与乳腺癌和妇科癌症的发病率和死亡率:一项使用国民健康保险索赔数据库的队列研究。

Statin use and incidence and mortality of breast and gynecology cancer: A cohort study using the National Health Insurance claims database.

机构信息

Department of Research, Health Insurance Review & Assessment Service, Wonju, Republic of Korea.

Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.

出版信息

Int J Cancer. 2022 Apr 1;150(7):1156-1165. doi: 10.1002/ijc.33869. Epub 2021 Dec 6.

Abstract

Previous studies have reported inconsistent findings concerning the impact of statin use on cancer prevention. Our study examined the association between statin use and cancer incidence and mortality related to breast and gynecologic cancers in South Korea. A population-based cohort study was conducted using the National Health Insurance claims database. Women aged 45 to 70 years old who had taken statins for at least 6 months were compared to statin non-users of the same age from January 2005 to June 2013. The primary outcomes were cancer incidence and mortality related to breast cancer, total gynecologic cancers, cervix uteri cancer and ovarian cancer. Cox proportional hazards regression was conducted to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs). Out of 587 705 women, there were 3591 cases of breast cancer, 2239 cases of gynecologic cancers and 565 breast and total gynecologic cancer deaths during 7.6 person-years. The aHRs for the association between the risk of each cancer and statin use were 0.88 (95% CI 0.79-0.97) for breast cancer and 0.83 (95% CI 0.67-0.99) for cervix uteri cancer. Statin use was associated with decreased breast cancer mortality (HR = 0.65, 95% CI 0.43-0.99) and total gynecologic cancer mortality (HR = 0.70, 95% CI 0.50-0.98). A dose-response relationship was only found for all-cancer mortality. Statin use for at least 6 months was significantly associated with a lower risk of breast and cervix uteri cancer incidence, and with lower mortality of breast and gynecologic cancers. Further research on these associations will be needed.

摘要

先前的研究报告指出,他汀类药物的使用对癌症预防的影响结果并不一致。我们的研究旨在检验他汀类药物的使用与韩国乳腺癌和妇科癌症的发病和死亡风险之间的关联。本研究采用基于人群的队列研究设计,利用国家健康保险索赔数据库进行分析。将年龄在 45 岁至 70 岁之间、至少服用 6 个月他汀类药物的女性与年龄相同但未服用他汀类药物的女性进行比较。主要结局指标为乳腺癌、所有妇科癌症、宫颈癌和卵巢癌的发病和死亡情况。采用 Cox 比例风险回归分析计算调整后的危险比(aHR)和 95%置信区间(95%CI)。在 587705 名女性中,有 3591 例乳腺癌、2239 例妇科癌症和 565 例乳腺癌和所有妇科癌症死亡。与他汀类药物使用相关的每种癌症风险的 aHR 分别为乳腺癌 0.88(95%CI 0.79-0.97)和宫颈癌 0.83(95%CI 0.67-0.99)。他汀类药物的使用与乳腺癌死亡率降低相关(HR=0.65,95%CI 0.43-0.99)和所有妇科癌症死亡率降低相关(HR=0.70,95%CI 0.50-0.98)。仅发现全因死亡率与剂量呈负相关。至少使用 6 个月的他汀类药物与乳腺癌和宫颈癌的发病风险降低以及乳腺癌和妇科癌症的死亡率降低显著相关。需要进一步研究这些关联。

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