Rosenberg L, Louik C, Shapiro S
Slone Epidemiology Unit, Boston University School of Medicine, Brookline, Massachusetts 02146, USA.
Cancer. 1998 Jun 15;82(12):2326-33. doi: 10.1002/(sici)1097-0142(19980615)82:12<2326::aid-cncr5>3.0.co;2-q.
Animal experiments and epidemiologic data have suggested that the use of nonsteroidal antiinflammatory drugs (NSAIDs) may decrease the incidence of large bowel carcinoma. Our purpose was to assess the relation of the use of aspirin and nonaspirin NSAIDs with the risk of large bowel carcinoma.
A population-based case-control study of colon and rectal carcinoma was conducted in Massachusetts from 1992 to 1994. Data on NSAID use and risk factors for large bowel carcinoma were collected by interview from 1201 incident cases of large bowel carcinoma and 1201 controls matched by age, gender, and area of residence.
Regular NSAID use that continued into the year before diagnosis was associated with a significantly decreased relative risk estimate overall (0.7; 95% confidence interval [CI], 0.5-0.8) and among Stage II-IV tumors (0.6; 95% CI, 0.4-0.7). There was no reduction in risk for discontinued use. The inverse association with regular continuing use was present across age and gender and for both colon and rectal carcinoma. Similar inverse associations were present for regular continuing use of aspirin and nonaspirin NSAIDs. There was no significant evidence of a trend for the relative risk to decrease as the duration of use increased, nor was there a trend across the dose of aspirin, which ranged from less than one-half of a 325 mg tablet per day to > or = 2 tablets per day. Discontinuation of use in response to symptoms of carcinoma did not appear to explain the inverse association, nor did bias related to diagnosis of the carcinoma.
These data add to the growing body of evidence that suggests a protective effect of NSAIDs against large bowel carcinoma.
动物实验和流行病学数据表明，使用非甾体抗炎药（NSAIDs）可能会降低大肠癌的发病率。我们的目的是评估阿司匹林和非阿司匹林类NSAIDs的使用与患大肠癌风险之间的关系。
1992年至1994年在马萨诸塞州进行了一项基于人群的结肠癌和直肠癌病例对照研究。通过访谈收集了1201例大肠癌新发病例和1201例年龄、性别和居住地区匹配的对照者的NSAIDs使用情况及大肠癌危险因素数据。
持续到诊断前一年的规律NSAIDs使用与总体相对风险估计值显著降低相关（0.7；95%置信区间[CI]，0.5 - 0.8），在II - IV期肿瘤患者中也是如此（0.6；95%CI，0.4 - 0.7）。停药者风险未降低。在各年龄和性别组以及结肠癌和直肠癌患者中，均存在规律持续用药与风险呈负相关的情况。规律持续使用阿司匹林和非阿司匹林类NSAIDs也存在类似的负相关。没有显著证据表明相对风险随使用时间增加而降低，也没有发现阿司匹林剂量范围（从每天少于半片325毫克片剂到≥2片/天）与风险之间存在趋势关系。因癌症症状而停药似乎无法解释这种负相关关系，与癌症诊断相关的偏倚也不能解释。
这些数据进一步证明了NSAIDs对大肠癌具有保护作用，相关证据越来越多。
