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非ステロイド性抗炎症薬と口腔がんのリスク: ネストケース・コントロール研究

J Sudbø¹, J J Lee, S M Lippman

¹Department of Medical Oncology and Radiotherapy, The Norwegian Radium Hospital, Montebello, 0310 Oslo, Norway. jon.sudbo@rh.uio.no

Lancet (London, England)

|October 18, 2005

まとめ

非ステロイド性抗炎症薬 (NSAIDs) は,特に喫煙者において,口腔がんのリスクを減らす可能性があります. しかし,長期にわたるNSAIDの使用は,心臓血管疾患による死亡のリスクが高いことと関連しており,注意深くリスク・利益の評価が必要である.

科学分野:

腫瘍学腫瘍学
心血管医学心血管医学
薬理学薬理学とは

背景:

非ステロイド性抗炎症薬 (NSAIDs) は,がん予防の可能性を示していますが,心血管疾患のリスクがあります.
NSAIDの使用と口腔がんの発生率または死亡率の関連性は,まだ完全に理解されていません.

研究の目的:

NSAIDの使用と口腔がんの発生率との関係を調査する.
NSAIDの使用が全体および心血管疾患による死亡率に与える影響を調査する.

主な方法:

ノルウェーのコホート (CONOR) データベースのデータを用いて,ネストされた症例対照研究が行われました.
口腔がんとマッチングされた対照群の個人は,大喫煙者 (≥15パック年) から選択されました.
NSAIDとパラセタモールの使用 (最低6ヶ月) は,口腔がんの診断と死亡率の結果に関連して分析されました.

主要な成果:

NSAIDの使用は,活発な喫煙者でも,口腔がんのリスクが著しく低下した (HR 0.47,P<0.0001) と関連していました.
長期のNSAID使用は,心血管疾患に関連する死亡のリスクの増加と相関していた (HR 2.06,P=0.001).
パラセタモールの使用は,口腔がんのリスクや心血管疾患による死亡率と有意な関連性を示さなかった.

結論:

長期にわたるNSAIDの使用は,口腔がんの発生率を潜在的に減少させますが,心血管疾患による死亡のリスクが高まります.
長期にわたるNSAID治療を検討する際には,徹底したリスク・利益分析が不可欠です.

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