长期服用阿司匹林或可降低确诊后的大肠癌死亡率
创作:szx 审核:szx 02月22日
  • 纳入4617名非转移性结直肠癌(CRC)患者,随访期间共763例CRC死亡;
  • 确诊前长期日常服用阿司匹林(每个月15次以上)与CRC死亡率降低显著相关(HR=0.69);
  • 确诊后开始日常服用阿司匹林与CRC死亡率无显著关联,但相比于确诊前后均未服用阿司匹林的患者,在确诊后开始日常服用的患者的CRC死亡率显著降低(HR=0.60);
  • 确诊前长期服用阿司匹林与CRC远端转移风险降低显著相关(HR=0.37);
  • 其它非甾体类抗炎药的结果与阿司匹林类似。
主编推荐语
szx
阿司匹林使用可能降低结直肠癌发病风险,但阿司匹林及其它非甾体类抗炎药与结直肠癌死亡率的关联尚未明确。JNCI-Journal of the National Cancer Institute上发表的一项前瞻性队列研究结果,对近5000名结直肠癌患者进行多年随访后发现,确诊前即开始长期服用阿司匹林或其它非甾体类抗炎药,与患者的结直肠癌死亡率降低显著相关。而在确诊后才开始服用阿司匹林的患者,结直肠癌死亡率也出现了显著的降低。
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Associations of aspirin and non-aspirin non-steroidal anti-inflammatory drugs with colorectal cancer mortality after diagnosis

阿司匹林及除阿司匹林外的非甾体类抗炎药与确诊后的结直肠癌死亡率的关联

10.1093/jnci/djab008

02-02, Article

Abstract & Authors:展开

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Background: Aspirin-use reduces colorectal cancer (CRC) incidence, but there is limited evidence regarding associations of aspirin and non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) with CRC-specific survival.
Methods: This prospective analysis includes women and men from the Cancer Prevention Study-II Nutrition Cohort who were cancer-free at baseline (1992 or 1993) and diagnosed with CRC during incidence follow-up through 2015. Detailed information on aspirin and non-aspirin NSAID-use was self-reported on questionnaires at baseline, in 1997, and every 2 years thereafter. Pre- and post-diagnosis data were available for 2,686 and 1,931 participants without distant-metastases, respectively, among whom 512 and 251 died from CRC during mortality follow-up through 2016. Secondary analyses examined associations between pre-diagnosis aspirin-use and stage at diagnosis (distant-metastatic versus localized or regional). All statistical tests were two-sided.
Results: Long-term regular use of aspirin (>15 times per month) before diagnosis was associated with lower CRC-specific mortality (multivariable-adjusted hazard ratio (HR)= 0.69; 95% CI = 0.52–0.92). Post-diagnosis regular aspirin use was not statistically significantly associated with risk of CRC-specific mortality overall (HR = 0.82; 95% CI = 0.62–1.09), although participants who began regular aspirin use only after their diagnosis were at lower risk than participants who did not use aspirin at both the pre-and post-diagnosis periods (HR = 0.60; 95% CI = 0.36–0.98). Long-term aspirin use before diagnosis was also associated with lower odds of diagnosis with distant metastases (multivariable-adjusted odds ratio = 0.73; 95% CI = 0.53–0.99).
Conclusions: Our results suggest that long-term aspirin use before a diagnosis of non-metastatic colorectal cancer may be associated with lower CRC-specific mortality after diagnosis, consistent with possible inhibition of micro-metastases before diagnosis.

First Authors:
Jane C Figueiredo

Correspondence Authors:
Peter T Campbell

All Authors:
Jane C Figueiredo,Eric J Jacobs,Christina C Newton,Mark A Guinter,William G Cance,Peter T Campbell

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