University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
Southampton Clinical Trials Unit, University of Southampton, UK.
Pancreatology. 2024 Sep;24(6):947-953. doi: 10.1016/j.pan.2024.08.005. Epub 2024 Aug 10.
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) usage has been associated with pancreatic ductal adenocarcinoma (PDAC) prevention, though epidemiological data have not reliably demonstrated this. The aim of this study is to identify if aspirin and other NSAIDs are effective in the primary prevention of PDAC in a large UK prospective cohort.
A nested case-control study was conducted using the UK Biobank cohort. Incident PDAC cases (n = 1129 of whom 239 (21.2 %) were using aspirin) were age and sex-matched with cancer-free controls (n = 8822 of whom 1752 (19.9 %) were using aspirin). Conditional logistic regression models were used to generate odds ratios (ORs) and 95 % confidence intervals (CI) for risk of PDAC with and without regular use of aspirin, non-aspirin NSAIDs and all NSAIDs respectively. Exploratory analyses were carried out assessing interactions with diabetes mellitus (DM) as a condition with increased pancreatic cancer risk.
Regular aspirin use at initial recruitment was independently associated with a decreased risk of PDAC (OR [95 % CI] = 0.80 [0.68-0.95] P = 0.01). Regular non-aspirin NSAID use was not associated with a risk reduction of PDAC (OR [95 % CI] = 1.01 [0.84-1.23] P = 0.88). Exploratory analyses showed that in those with DM; regular aspirin use reduced risk of PDAC (OR [95 % CI] = 0.60 [0.42-0.85] P = 0.004) compared to non-use.
Regular aspirin use is associated with a reduction in risk of PDAC. The reduced risk is more apparent in participants with DM.
阿司匹林和其他非甾体抗炎药（NSAIDs）的使用与胰腺导管腺癌（PDAC）的预防有关，尽管流行病学数据并未可靠地证明这一点。本研究的目的是在英国大型前瞻性队列中确定阿司匹林和其他 NSAIDs 是否能有效预防 PDAC。
使用英国生物库队列进行嵌套病例对照研究。将 PDAC 病例（n=1129 例，其中 239 例（21.2%）正在使用阿司匹林）与无癌症对照者（n=8822 例，其中 1752 例（19.9%）正在使用阿司匹林）按年龄和性别匹配。使用条件逻辑回归模型生成使用阿司匹林、非阿司匹林 NSAIDs 和所有 NSAIDs 的情况下，PDAC 风险的比值比（OR）和 95%置信区间（CI）。进行了探索性分析，以评估与糖尿病（DM）作为增加胰腺癌风险的疾病之间的相互作用。
在最初招募时经常使用阿司匹林与 PDAC 风险降低独立相关（OR [95%CI] = 0.80 [0.68-0.95]，P=0.01）。经常使用非阿司匹林 NSAID 与 PDAC 风险降低无关（OR [95%CI] = 1.01 [0.84-1.23]，P=0.88）。探索性分析表明，在患有 DM 的人群中；与不使用相比，经常使用阿司匹林可降低 PDAC 的风险（OR [95%CI] = 0.60 [0.42-0.85]，P=0.004）。
经常使用阿司匹林与 PDAC 风险降低相关。在患有 DM 的参与者中，风险降低更为明显。
