Use of Nonsteroidal Anti-Inflammatory Drugs and Pancreatic Cancer Risk in the Women's Health Initiative.

IF 3.7 3区 医学 Q2 ONCOLOGY
Theodore M Brasky, Leah R Jager, Alison M Newton, Xilin Li, Holli A Loomans-Kropp, John L Hays, Karen L Margolis, Juhua Luo
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Abstract

Background: Pancreatic cancer is among the most fatal human cancers and the fourth leading cause of cancer death in the United States. Evidence suggests that chronic inflammation may play a role in pancreatic carcinogenesis and its inhibition through nonsteroidal anti-inflammatory drugs (NSAID) may reduce pancreatic cancer incidence.

Methods: We examined associations of total and individual NSAIDs with pancreatic cancer risk among postmenopausal women participating in the Women's Health Initiative observational study and clinical trial cohorts. Among 117,452 women, aged 55 to 79 years, 727 incident pancreatic cancer cases were reported over 18 years of follow-up. Cox regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for associations between NSAIDs and pancreatic cancer risk.

Results: Relative to non-use, consistent use of any NSAID was inversely associated with pancreatic cancer risk (HR 0.71, 95% CI, 0.59-0.87), primarily driven by strong associations for aspirin use (HR 0.67, 95% CI, 0.52-0.86). Use of total or individual non-aspirin NSAIDs was not associated with pancreatic cancer. Upon stratified analysis, we observed stronger associations for NSAIDs among participants with prevalent diabetes (HR 0.28, 95% CI, 0.10-0.75) relative to those without (HR 0.75, 95% CI, 0.61-0.92; P-interaction = 0.03).

Conclusions: Additional large prospective studies with careful measurement of NSAID type, dose, and frequency are needed to further investigate the possibility of added benefit among individuals diagnosed with diabetes.

Impact: This study adds to existing evidence from prospective studies and clinical trials suggesting that use of aspirin may provide moderate benefit for pancreatic cancer prevention.

妇女健康倡议》(Women's Health Initiative)中非甾体抗炎药的使用与胰腺癌风险。
背景:胰腺癌是最致命的人类癌症之一,也是美国癌症死亡的第四大原因。有证据表明,慢性炎症可能在胰腺癌的发生中起作用,而通过非甾体抗炎药(NSAIDs)抑制慢性炎症可能会降低胰腺癌的发病率:我们研究了参与 "妇女健康倡议 "观察研究和临床试验队列的绝经后妇女中,非甾体抗炎药总量和单项非甾体抗炎药与胰腺癌风险的关系。在117,452名55-79岁的女性中,在18年的随访中报告了727例胰腺癌病例。结果显示:相对于不使用非甾体抗炎药,持续使用非甾体抗炎药的女性患胰腺癌的风险更高:与不使用非甾体抗炎药相比,持续使用任何非甾体抗炎药与胰腺癌风险成反比(HR 0.71,95% CI:0.59-0.87),这主要是由于阿司匹林的使用与胰腺癌风险密切相关(HR 0.67,95% CI:0.52-0.86)。使用全部或单个非阿司匹林类非甾体抗炎药与胰腺癌无关。通过分层分析,我们观察到非甾体抗炎药与糖尿病患者的关系(HR 0.28,95% CI:0.10-0.75)比与非糖尿病患者的关系(HR 0.75,95% CI:0.61-0.92;P-交互作用=0.03)更密切:结论:需要进行更多的大型前瞻性研究,仔细测量非甾体抗炎药的类型、剂量和频率,以进一步研究在确诊糖尿病患者中增加获益的可能性:本研究补充了前瞻性研究和临床试验的现有证据,表明使用阿司匹林可为预防胰腺癌带来适度益处。
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来源期刊
Cancer Epidemiology Biomarkers & Prevention
Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
2.60%
发文量
538
审稿时长
1.6 months
期刊介绍: Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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