BACKGROUND:NSAIDs appear to moderately reduce prostate cancer risk. However, evidence is limited on whether NSAIDs protect against prostate cancer mortality (death from prostate cancer among men without a cancer history) and case fatality (death from prostate cancer among men with prostate cancer), and whether benefits are consistent in white and black men. This study investigated associations of aspirin and non-aspirin (NA) NSAID use with prostate cancer incidence, mortality, and case fatality in a population-based cohort of white and black men. METHODS:We included 6,594 men (5,060 white and 1,534 black) from the Atherosclerosis Risk in Communities study without a cancer history at enrollment from 1987 to 1989. NSAID use was assessed at four study visits (1987-1998). Cancer outcomes were ascertained through 2012. Cox proportional hazards regression was used to estimate adjusted HRs, overall and by race. RESULTS:Aspirin use was not associated with prostate cancer incidence. However, aspirin use was inversely associated with prostate cancer mortality [HR, 0.59; 95% confidence interval (CI), 0.36-0.96]. This association was consistent among white and black men and appeared restricted to men using aspirin daily and/or for cardiovascular disease prevention. Aspirin use was inversely associated with case fatality (HR, 0.45; 95% CI, 0.22-0.94). NA-NSAID use was not associated with these endpoints. CONCLUSIONS:Aspirin use was inversely associated with prostate cancer mortality and case fatality among white and black men. IMPACT:If confirmed by additional studies, benefits of aspirin for preventing prostate cancer mortality may need to be factored into risk-benefit calculations of men considering an aspirin regimen.

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背景:NSAIDs似乎可适度降低前列腺癌的风险。但是,关于NSAID是否能预防前列腺癌的死亡率(无癌症病史的男性死于前列腺癌)和病死率(前列腺癌的男性死于前列腺癌),以及白人和黑人的益处是否一致,目前的证据有限。 。这项研究调查了阿司匹林和非阿司匹林(NA)NSAID的使用与白人和黑人人群中前列腺癌的发生率,死亡率和病死率之间的关系。
方法:我们纳入了从1987年至1989年入组的无动脉粥样硬化史的来自社区动脉粥样硬化风险研究的6,594名男性(5,060名白人和1,534名黑人)。在四次研究访问(1987年至1998年)中评估了NSAID的使用。在2012年之前确定癌症的结局。使用Cox比例风险回归法估算总体和种族的调整后HR。
结果:阿司匹林的使用与前列腺癌的发病率无关。然而,阿司匹林的使用与前列腺癌的死亡率呈负相关[HR,0.59; H。 95%置信区间(CI),0.36-0.96]。白人和黑人男性之间的这种联系是一致的,并且似乎仅限于每天使用阿司匹林和/或预防心血管疾病的男性。阿司匹林的使用与病死率成反比(HR,0.45; 95%CI,0.22-0.94)。 NA-NSAID的使用与这些端点无关。
结论:阿司匹林的使用与白人和黑人男性的前列腺癌死亡率和病死率成反比。
影响:如果通过其他研究证实,在考虑使用阿司匹林方案的男性的风险收益计算中,可能需要考虑阿司匹林预防前列腺癌死亡的益处。

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