BACKGROUND:Statins and nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with reduced risk of colorectal cancer (CRC) in some studies. The objective of this study was to quantify the relative risk of inflammatory bowel disease (IBD) as a risk factor for CRC and to estimate whether this risk may be modified by long-term use of NSAIDs or statins. METHODS:The Molecular Epidemiology of Colorectal Cancer study is a population-based, case-control study of incident colorectal cancer in northern Israel and controls matched by age, sex, clinic, and ethnicity. Personal histories of IBD and medication use were measured by structured, in-person interview. The relative risk of IBD and effect modification by statins and NSAIDs were quantified by conditional and unconditional logistic regression. RESULTS:Among 1921 matched pairs of CRC cases and controls, a self-reported history of IBD was associated with a 1.9-fold increased risk of CRC (95% confidence interval [CI], 1.12-3.26). Long-term statin use was associated with a reduced risk of both IBD-associated CRC (odds ratio [OR] = 0.07; 95% CI, 0.01-0.78) and non-IBD CRC (OR = 0.49; 95% CI, 0.39-0.62). Stratified analysis suggested that statins may be more protective among those with IBD (ratio of OR = 0.14; 95% CI, 0.01-1.31; P = .51), although not statistically significant. NSAID use in patients with a history of IBD was suggestive of reduced risk of CRC but did not reach statistical significance (OR = 0.47; 95% CI, 0.12-1.86). CONCLUSIONS:The risk of CRC was elevated 1.9-fold in patients with IBD. Long-term statin use was associated with reduced risk of CRC in patients with IBD.

译文

背景:在一些研究中,他汀类药物和非甾体抗炎药(NSAID)与降低结直肠癌(CRC)的风险有关。这项研究的目的是量化炎症性肠病(IBD)作为CRC的危险因素的相对风险,并估计长期使用NSAID或他汀类药物是否可以改变这种风险。
方法:结肠直肠癌的分子流行病学研究是一项基于人群的病例对照研究,研究对象是以色列北部地区的结肠直肠癌,并按年龄,性别,诊所和种族进行了对照。 IBD的个人病史和药物使用情况是通过结构化的面对面访谈来衡量的。 IBD的相对风险以及他汀类药物和非甾体抗炎药对效应的影响通过有条件和无条件逻辑回归进行定量。
结果:在1921对配对的CRC病例和对照中,IBD的自我报告病史与CRC风险增加1.9倍相关(95%置信区间[CI],1.12-3.26)。长期使用他汀类药物与IBD相关CRC(比值比[OR] = 0.07; 95%CI,0.01-0.78)和非IBD CRC(OR = 0.49; 95%CI,0.39- 0.62)。分层分析表明,他汀类药物在IBD患者中可能具有更好的保护作用(OR = 0.14; 95%CI,0.01-1.31; P = .51),尽管无统计学意义。有IBD病史的患者使用NSAID提示CRC风险降低,但未达到统计学意义(OR = 0.47; 95%CI,0.12-1.86)。
结论:IBD患者的CRC风险升高了1.9倍。长期使用他汀类药物可降低IBD患者的CRC风险。

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