Egan K M, Stampfer M J, Giovannucci E, Rosner B A, Colditz G A
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
J Natl Cancer Inst. 1996 Jul 17;88(14):988-93. doi: 10.1093/jnci/88.14.988.
Evidence suggests that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can inhibit tumor development in the large bowel. An inverse association between the use of NSAIDs and the incidence of breast cancer has been observed, but this association has not been statistically significant in all studies.
We analyzed data from the prospective Nurses' Health Study to evaluate the influence of aspirin use on breast cancer risk.
We studied a population of 89,528 female registered nurses who reported no history of breast or other cancers (excluding nonmelanoma skin cancer) and who returned a mailed questionnaire in 1980 that elicited information concerning breast cancer risk factors and current and past aspirin use. Follow-up questionnaires were mailed to the participants every 2 years; the women were followed through 1992. Information concerning current aspirin use was obtained from each biennial questionnaire, except in 1986. Cases of breast cancer were identified through questionnaire responses, and permission was sought for a review of medical records to confirm the diagnoses. Our analysis was based on 2414 cases of invasive breast cancer, which included 2303 cases confirmed with medical records and 111 cases for which no records were obtained. Relative risks (RRs) with 95% confidence intervals (CIs), adjusted for age or age plus other known or potential breast cancer risk factors (i.e., multivariate), were calculated.
Regular aspirin use (two or more tablets per week) in 1980 was unrelated to breast cancer incidence during the succeeding 12-year period (with no regular aspirin use as the referent, multivariate RR = 1.03; 95% CI = 0.95-1.12). The corresponding risk estimate for consistent regular aspirin use during the period from 1980 through 1988 was 1.01 (95% CI = 0.80-1.27). The risks were similar for heavy aspirin use (for more than two tablets per day [i.e., > 14 per week] in 1980 and in 1980 through 1988, the multivariate RRs [95% CIs] were 1.05 [0.89-1.23] and 1.09 [0.75-1.60], respectively) and for extended durations of regular use (e.g., for 20 years or more of regular use, multivariate RR = 1.00; 95% CI = 0.71-1.41).
Our results indicate that regular aspirin use does not reduce the risk of breast cancer.
有证据表明，阿司匹林和其他非甾体抗炎药（NSAIDs）可抑制大肠肿瘤的发展。已观察到NSAIDs的使用与乳腺癌发病率之间存在负相关，但在所有研究中这种关联在统计学上并不显著。
我们分析了前瞻性护士健康研究的数据，以评估阿司匹林的使用对乳腺癌风险的影响。
我们研究了89528名女性注册护士，她们报告无乳腺癌或其他癌症病史（不包括非黑色素瘤皮肤癌），并在1980年回复了一份邮寄问卷，该问卷收集了有关乳腺癌风险因素以及当前和过去阿司匹林使用情况的信息。每两年向参与者邮寄一次随访问卷；对这些女性的随访至1992年。除1986年外，每次两年期问卷均获取了有关当前阿司匹林使用情况的信息。通过问卷回复确定乳腺癌病例，并征得同意查阅病历以确认诊断。我们的分析基于2414例浸润性乳腺癌病例，其中包括2303例经病历确认的病例和111例未获取病历的病例。计算了经年龄或年龄加其他已知或潜在乳腺癌风险因素调整后的相对风险（RRs）及95%置信区间（CIs）（即多变量分析）。
1980年定期服用阿司匹林（每周两片或更多）与随后12年期间的乳腺癌发病率无关（以未定期服用阿司匹林为对照，多变量RR = 1.03；95% CI = 0.95 - 1.12）。1980年至1988年期间持续定期服用阿司匹林的相应风险估计值为1.01（95% CI = 0.80 - 1.27）。大量服用阿司匹林（1980年每天两片以上[即每周>14片]以及1980年至1988年期间）的风险相似，多变量RRs（95% CIs）分别为1.05（0.89 - 1.23）和1.09（0.75 - 1.60），长期定期服用（例如，定期服用20年或更长时间）的风险也相似，多变量RR = 1.00；95% CI = 0.71 -
我们的结果表明，定期服用阿司匹林不会降低患乳腺癌的风险。 1.41）。
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