JNCI：每日服用阿司匹林和低癌症死亡率直接相关

一项大型的观察性研究发现了日常阿司匹林摄入和低癌症死亡率相关的大量证据，相关研究报告刊登在了近日的国际杂志the Journal of the National Cancer Institute（JNCI）上，为日常阿司匹林使用于低癌症死亡率提供了支持。

文章中，研究者表示，使用阿司匹林5年及以上的人群，其癌症死亡率的风险可降低37%。但是又有很多问题存在，比如说，每天服用多少阿司匹林才能降低癌症死亡率等等。

研究者Eric分析了100，139位癌症老年患者的信息，发现每日服用阿司匹林可使其癌症死亡风险降低16%，研究中的癌症死亡风险降低率（16%）相比大量随机比对试验的死亡降低率（37%）明显小了，研究者表示，他们的研究是观察检测得到的，而并非是随机试验而来。

制定临床指导方针的专家委员会会考虑阿司匹林的风险和益处来制定最终的策略，当然尽管阿司匹林摄入和低癌症死亡率的结果鼓舞人心，但是也不能盲目告诉人们开始服用阿司匹林来抑制癌症发生。甚至低剂量的阿司匹林还会增加严重的胃肠道出血的风险。服用阿司匹林最好还是在专家的指导下来进行。

编译自：Daily Aspirin Usage Linked to Lower Cancer Mortality

doi:10.1093/jnci/djs318
PMC:
PMID:

Daily Aspirin Use and Cancer Mortality in a Large US Cohort

Eric J. Jacobs, Christina C. Newton, Susan M. Gapstur and Michael J. Thun

Background A recent pooled analysis of randomized trials of daily aspirin for prevention of vascular events found a substantial reduction (relative risk [RR] = 0.63, 95% confidence interval [CI] = 0.49 to 0.82) in overall cancer mortality during follow-up occurring after 5 years on aspirin. However, the magnitude of the effect of daily aspirin use, particularly long-term use, on cancer mortality is uncertain. Methods We examined the association between daily aspirin use and overall cancer mortality among 100 139 men and women with no history of cancer in the Cancer Prevention Study II Nutrition Cohort. Cox proportional hazards regression models were used to estimate multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs). Results Between 1997 and 2008, 5138 participants died from cancer. Compared with no use, daily aspirin use at baseline was associated with slightly lower cancer mortality, regardless of duration of daily use (for <5 years of use, RR = 0.92, 95% CI = 0.85 to 1.01; for ≥5 years of use, RR = 0.92, 95% CI = 0.83 to 1.02). Associations were slightly stronger in analyses that used updated aspirin information from periodic follow-up questionnaires and included 3373 cancer deaths (for <5 years of use, RR = 0.84, 95% CI = 0.76 to 0.94; for ≥5 years of use, RR = 0.84, 95% CI = 0.75 to 0.95). Conclusion These results are consistent with an association between recent daily aspirin use and modestly lower cancer mortality but suggest that any reduction in cancer mortality may be smaller than that observed with long-term aspirin use in the pooled trial analysis.