アスピリン服用で非噴門部胃ガンのリスクが減少する

 アスピリン服用で非噴門部胃ガンのリスクが1/3減少する。
 英国の30万人以上の人々の追跡で、アスピリン服用者は胃の中下部のガンの発症が低かったが、出血の危険性も増大することから現時点でガン予防のための服用は推奨されない。
 311,115人を約7年間追跡した研究で、研究開始前12ヶ月間の鎮痛剤使用歴を調査した。73%がアスピリンを、56%が他のNSAIDsを少なくとも1回使用した。
 非噴門部胃ガンの発生がアスピリン服用者で10万人あたり11人だったが、非服用者では7人だった。ibuprofenなどの他のNSAIDsでも32%低下が見られた。以前に行われた研究と異なり、食道ガンや噴門ガンではそうした効果は見られなかった。
 リスクベネフィットを含めた予防効果を確かめるには、二重盲検法による臨床試験が必要である。
 英国では年に約8,000人が胃ガンと診断され、約5,250人が死亡している。
 胃ガンの5年生存率は15%で、食道ガンは8%である。
 以前の研究で、アスピリンの規則的な長期使用がすい臓ガンのリスク増加と関連する可能性が示唆されている。
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Page last updated at 10:28 GMT, Friday, 6 February 2009
Aspirin cuts stomach cancer risk
http://news.bbc.co.uk/2/hi/health/7872036.stm

画像Aspirin
Regular aspirin use has been linked to abdominal bleeds.

A study has suggested using aspirin could cut the risk of developing a type of stomach cancer by up to a third.

The British Journal of Cancer study looked at over 300,000 people.
It found those who had taken aspirin in the previous year were far less likely to develop cancer of the middle or lower stomach.
Taking aspirin regularly is known to cut the risk of bowel cancer, but can have side effects, including causing bleeds within the abdomen.

It's far too early to recommend that people take aspirin to protect themselves from these cancers
Dr Lesley Walker, Cancer Research UK

Such side effects mean that doctors advise against regular aspirin use as a protection against cancer.
This study followed 311,115 people for around seven years and analysed their use of the painkillers in the 12 months prior to the study starting.
A total of 73% of the group had used aspirin and 56% had used other NSAIDs at least once in the 12 months prior to the start of the study.
A quarter reported daily aspirin use while 10% reported daily use of other NSAIDs.
The rate of non-cardia stomach cancer calculated in this study was seven per 100,000 person-years for aspirin users, compared with 11 per 100,000 person-years for non-users.
Each year in the UK, around 8,000 people are diagnosed with stomach cancer, and around 5,250 people die from the disease.

Survival rates
There was also a 32% reduction for the same type of stomach cancer, non-cardia gastric cancer, in people who used other types of non-steroidal anti-inflammatory drugs - or NSAIDs - such as ibuprofen.
In contrast to results of previous studies, the researchers found that aspirin does not protect against oesophageal cancer and cardia gastric cancer - cancer of the top of the stomach.
Scientists believe that placebo controlled trials, which would assess risks and benefits should be conducted to see if NSAIDs can be used to protect against stomach and oesophageal cancers.
Five year survival rates for stomach cancers is just 15%, and for oesophageal cancers it is 8%.

'Talk to your doctor'
Dr Christian Abnet, of the National Cancer Institute in America who led the research, said: "We found that the risk of non-cardia stomach cancer was lower in people who had taken aspirin, and this risk lowered the more regularly they took it.
"Interestingly, our results didn't show a significant cut in the risk of oesophageal or cardia stomach cancer, so it's important that we continue to review data that suggests otherwise."
He added: "The number of people who survive at least five years following a diagnosis of stomach or oesophageal cancer is low, so it's important to increase our understanding of ways to prevent the disease and to investigate aspirin as a possible preventative drug."
He suggested that a further research should be carried out to further investigate the apparent protective benefits of aspirin and other NSAIDs, and the risk of side-effects.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "It's far too early to recommend that people take aspirin to protect themselves from these cancers.
"In cancers where survival is low, understanding how to prevent the disease is crucial, but more research is needed to discover how side effects can be balanced with the benefits.
"Cancer Research UK would urge people to speak to their doctor before taking aspirin regularly."
Previous research has suggested regular long-term use of aspirin may be associated with an increased risk of pancreatic cancer.

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British Journal of Cancer (2009) 100, 551–557. doi:10.1038/sj.bjc.6604880 www.bjcancer.com
Published online 20 January 2009
Non-steroidal anti-inflammatory drugs and risk of gastric and oesophageal adenocarcinomas: results from a cohort study and a meta-analysis

C C Abnet1, N D Freedman1, F Kamangar1, M F Leitzmann1,3, A R Hollenbeck2 and A Schatzkin1

1. 1Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
2. 2AARP, Washington, DC, USA

Correspondence: Dr C Abnet, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 320, 6120 Executive Blvd, MSC 7232, Rockville, MD 20852, USA. E-mail: abnetc@mail.nih.gov

3Current address: Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany

Received 14 October 2008; Revised 12 December 2008; Accepted 15 December 2008; Published online 20 January 2009.
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Abstract

Use of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the risk of gastric or oesophageal adenocarcinomas. We examined the association between self-reported use of aspirin or non-aspirin NSAIDs in the earlier 12 months and gastric non-cardia (N=182), gastric cardia (N=178), and oesophageal adenocarcinomas (N=228) in a prospective cohort (N=311 115) followed for 7 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) come from Cox models adjusted for potential confounders. Use of any aspirin (HR, 95% CI: 0.64, 0.47–0.86) or other NSAIDs (0.68, 0.51–0.92) was associated with a significantly lower risk of gastric non-cardia adenocarcinoma. Neither aspirin (0.86, 0.61–1.20) nor other NSAIDs (0.91, 0.67–1.22) had a significant association with gastric cardia cancer. We found no significant association between using aspirin (1.00, 0.73–1.37) or other NSAIDs (0.90, 69–1.17) and oesophageal adenocarcinoma. We also performed a meta-analysis of the association between the use of NSAIDs and risk of gastric and oesophageal adenocarcinoma. In this analysis, aspirin use was inversely associated with both gastric and oesophageal adenocarcinomas, with summary odds ratios (95% CI) for non-cardia, cardia, and oesophageal adenocarcinomas of 0.64 (0.52–0.80), 0.82 (0.65–1.04), and 0.64 (0.52–0.79), respectively. The corresponding numbers for other NSAIDs were 0.68 (0.57–0.81), 0.80 (0.67–0.95), and 0.65 (0.50–0.85), respectively.
Keywords:

aspirin, NSAIDs, oesophageal cancer, gastric cancer, cohort, meta-analysis

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