坚持服用阿司匹林10年以上,或可预防大肠癌
创作:szx 审核:szx 02月22日
  • 纳入2个队列中的123,816名受试者进行多年随访,期间确诊2147例结直肠癌患者;
  • 在随访开始前的10年之前(很久之前),与从未服用阿司匹林者相比,更长的阿司匹林使用时间与更低的结直肠癌风险相关,阿司匹林使用时间每增加5年,结直肠癌风险降低12%;
  • 在随访开始前的10年内(近期),可观察到相似关联,阿司匹林使用时间每增加5年,结直肠癌风险降低10%;
  • 在近期(而非很久之前),阿司匹林使用与结直肠癌风险之间存在剂量依赖性关联。
主编推荐语
szx
JNCI-Journal of the National Cancer Institute上发表的一项前瞻性队列研究,对超过12万名受试者进行多年随访后发现,长时间服用阿司匹林与结直肠癌风险降低相关,但这种益处需要至少6-10年的时间才得以显现,且与服用的剂量相关。而服用超过10年的时间,即使是低剂量的阿司匹林也对预防结直肠癌有益。
关键字
延伸阅读本研究的原文信息和链接出处,以及相关解读和评论文章。欢迎读者朋友们推荐!

Timing of aspirin use in colorectal cancer chemoprevention: a prospective cohort study

阿司匹林使用时间与结直肠癌化学预防:一项前瞻性队列研究

10.1093/jnci/djab009

02-02, Article

Abstract & Authors:展开

Abstract:收起
Background: Prior epidemiological and intervention studies have not been able to separate independent effects of dose, timing and duration of aspirin use in colorectal cancer (CRC) chemoprevention. We examined aspirin-based CRC chemoprevention according to timing in the Nurses’ Health Study and Health Professionals Follow-Up Study.
Methods: The exposures include cumulative average dose and total duration of aspirin use in > 10 years before follow-up started (remote period), and in the immediate 10 years before follow-up started (recent period). Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals for exposures and CRC risk.
Results: Aspirin use >10 years before follow-up started (HR = 0.88, 95% CI = 0.83 to 0.94) per 5 year increment) and immediate 10 years before follow-up started (HR = 0.90, 95% CI = 0.84 to 0.96) were similarly important in CRC chemoprevention, though a 5-year lag was required for a clear benefit in the recent period. In the remote period, the association was not dose-dependent; compared to < 0.5 standard (325 mg)-dose tablets/week; hazard ratios were HR = 0.78, 95% CI = 0.63 to 0.98, HR = 0.81, 95% CI = 0.72 to 0.91, and HR = 0.74, 95% CI = 0.64 to 0.86 for doses of 0.5 to < 1.5, 1.5 to < 5, ≥5 tablets/week, respectively. However, there was dose dependency in the recent period (with respective HR = 0.91, 95% CI = 0.79 to 1.06; HR = 0.87, 95% CI = 0.77 to 0.98; and HR = 0.76, 95% CI = 0.64 to 0.91).
Conclusion: A suggestive benefit necessitates at least 6–10 years and most clearly after approximately 10 years since initiation of aspirin. Remote use and use within the previous 10 years both contribute independently to decreased risk, though a lower dose may be required for a benefit with longer term use.

First Authors:
Yin Zhang

Correspondence Authors:
Edward L Giovannucci

All Authors:
Yin Zhang,Andrew T Chan,Jeffrey A Meyerhardt,Edward L Giovannucci

评论