Длительный прием малых доз аспирина уменьшает риск развития рака печени и рака яичников.
Два больших популяционных исследования ещё раз подтвердили положительное влияние минимальных (до 100 мг) доз аспирина на уменьшение риска возникновения раковых заболеваний.
Исследования здоровья медсестер (Nurses' Health studies) показали, что у женщин, которые регулярно принимали минимальную дозу аспирина, отмечалось снижение риска возникновения рака яичников на 23% по сравнению с теми, кто не принимал аспирин.
Второй анализ был проведен на основании двух исследований, Nurses’ Health Study и Health Professionals Follow-up Study. 133 371 участника/субъекта исследований отслеживались с 1980 и 1986 годов. В процессе анализа данных, проведенного в 2017 г., было выявлено 49% снижение риска возникновения гепатоцеллюлярной карциномы среди пациентов, длительно принимавших дважды в сутки низкие дозы обычного аспирина.
Оба исследования учитывали такие факторы как возраст, состояние менопаузы, наличие онкологических заболеваний в семейном анамнезе.
Эксперты отмечают, что преимущества приёма аспирина должны сопоставляться с риском возникновения кровотечений, особенно у людей с хроническими заболеваниями печени. И здесь важно правильно подобрать дозу, продолжительность приёма, а также чётко представлять механизмы действия аспирина.
Исследователи отмечают, что применение минимальных доз аспирина ведёт не только к профилактике сердечно-сосудистых заболеваний и ранее доказанному снижению риска возникновения рака прямой кишки, но и к снижению риска возникновения рака яичников и некоторых видов рака печени.
Источники: JAMA Oncol. 2018 Dec 1;4(12):1675-1682. doi: 10.1001/jamaoncol.2018.4149.
JAMA Oncol. 2018 Dec 1;4(12):1683-1690. doi: 10.1001/jamaoncol.2018.4154.
Association Between Aspirin Use and Risk of Hepatocellular Carcinoma.
Simon TG et al
IMPORTANCE:
Prospective data on the risk of hepatocellular carcinoma (HCC) according to dose and duration of aspirin therapy are limited.
OBJECTIVE:
To examine the potential benefits of aspirin use for primary HCC prevention at a range of doses and durations of use within 2 prospective, nationwide populations.
DESIGN, SETTING, AND PARTICIPANTS:
Pooled analysis of 2 prospective US cohort studies: the Nurses' Health Study and the Health Professionals Follow-up Study. Data were accessed from November 1, 2017, through March 7, 2018. A total of 133 371 health care professionals who reported data on aspirin use, frequency, dosage, and duration of use biennially since 1980 in women and 1986 in men were included. Individuals with a cancer diagnosis at baseline (except nonmelanoma skin cancer) were excluded.
MAIN OUTCOMES AND MEASURES:
Cox proportional hazards regression models were used to calculate multivariable adjusted hazard ratios (HRs) and 95% CIs for HCC.
RESULTS:
Of the 133 371 participants, 87 507 were women and 45 864 were men; in 1996, the median time of follow-up, the mean (SD) age was 62 (8) years for women and 64 (8) years for men. Over more than 26 years of follow-up encompassing 4 232 188 person-years, 108 incident HCC cases (65 women, 43 men) were documented. Compared with nonregular use, regular aspirin use (≥2 standard-dose [325-mg] tablets per week) was associated with reduced HCC risk (adjusted HR, 0.51; 95% CI, 0.34-0.77). This benefit appeared to be dose related: compared with nonuse, the multivariable-adjusted HR for HCC was 0.87 (95% CI, 0.51-1.48) for up to 1.5 standard-dose tablets per week, 0.51 (95% CI, 0.30-0.86) for more than 1.5 to 5 tablets per week, and 0.49 (95% CI, 0.28-0.96) for more than 5 tablets per week (P for trend = .006). Significantly lower HCC risk was observed with increasing duration (P for trend = .03); this decrease was apparent with use of 1.5 or more standard-dose aspirin tablets per week for 5 or more years (adjusted HR, 0.41; 95% CI, 0.21-0.77). In contrast, use of nonaspirin nonsteroidal anti-inflammatory drugs was not significantly associated with HCC risk (adjusted HR, 1.09; 95% CI, 0.78-1.51).
CONCLUSIONS AND RELEVANCE:
This study suggests that regular, long-term aspirin use is associated with a dose-dependent reduction in HCC risk, which is apparent after 5 or more years of use. Similar associations were not found with nonaspirin NSAIDs. Further research appears to be needed to clarify whether aspirin use represents a feasible strategy for primary prevention against H
Association of Analgesic Use With Risk of Ovarian Cancer in the Nurses' Health Studies.
Barnard ME
IMPORTANCE:
Ovarian cancer is a highly fatal malignant neoplasm with few modifiable risk factors. Case-control studies have reported a modest reduced risk of ovarian cancer among women who frequently use aspirin or regularly use low-dose aspirin.
OBJECTIVE:
To evaluate whether regular aspirin or nonaspirin nonsteroidal anti-inflammatory drug (NSAID) use and patterns of use are associated with lower ovarian cancer risk.
DESIGN, SETTING, AND PARTICIPANTS:
This cohort study analyzed NSAID use and ovarian cancer diagnosis data from 2 prospective cohorts, 93 664 women in the Nurses' Health Study (NHS), who were followed up from 1980 to 2014, and 111 834 in the Nurses' HealthStudy II (NHSII), who were followed up from 1989 to 2015. Follow-up was completed on June 30, 2014, for the NHS and June 30, 2015, for NHSII. Data were analyzed from June 13, 2016, to September 18, 2017.
EXPOSURES:
For each analgesic type (aspirin, low-dose aspirin, nonaspirin NSAIDs, and acetaminophen), timing, duration, frequency, and number of tablets used were evaluated; exposure information was updated every 2 to 4 years.
MAIN OUTCOMES AND MEASURES:
Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for associations of aspirin, nonaspirin NSAIDs, and acetaminophen with risk of epithelial ovarian cancer. All statistical tests were 2-sided, with a significance level of .05.
RESULTS:
In the NHS, the mean (SD) age at baseline (1980) was 45.9 (7.2) years, and 93% of participants identified as non-Hispanic white. In the NHSII, the mean age at baseline (1989) was 34.2 (4.7) years, and 92% identified as non-Hispanic white. Among the 205 498 women in both cohorts, there were 1054 cases of incident epithelial ovarian cancer. Significant associations between aspirin and ovarian cancer riskwere not observed when current vs nonuse of any aspirin was evaluated regardless of dose (HR, 0.99; 95% CI, 0.83-1.19). However, when low-dose (≤100-mg) and standard-dose (325-mg) aspirin were evaluated separately, an inverse association for low-dose aspirin (HR, 0.77; 95% CI, 0.61-0.96), but no association for standard-dose aspirin (HR, 1.17; 95% CI, 0.92-1.49) was observed. Current use of nonaspirin NSAIDs was positively associated with risk of ovarian cancer compared with nonuse (HR, 1.19; 95% CI, 1.00-1.41), and significant positive trends for duration of use (P = .02 for trend) and cumulative average tablets per week (P = .03 for trend) were observed. There were no clear associations for the use of acetaminophen.
CONCLUSIONS AND RELEVANCE:
These results appear to be consistent with case-control studies that show a reduced risk of ovarian cancer among regular users of low-dose aspirin. An increased risk of ovarian cancer with long-term high-quantity use of other analgesics, particularly nonaspirin NSAIDs, was observed, although this finding requires confirmation.