JAMA Oncology：阿司匹林能否降低老年人结直肠癌风险？取决于他们何时开始用药

2021-01-23 Allan MedSci原创

常规使用阿司匹林与降低的结直肠癌风险有关。但是，这一优势仅在70岁之前开始服用阿司匹林的人群中才有意义。

定期使用阿司匹林对降低中年成年人大肠癌的发病率有明显的益处，但也有一定的风险，例如胃肠道出血。成年人应该何时开始定期服用阿司匹林，持续多长时间？有大量证据表明，每天服用阿司匹林可以降低70岁以下成年人的结直肠癌风险。但是直到现在，还没有证据表明老年人是否应该开始服用阿司匹林。

由马萨诸塞州总医院（MGH）Andrew T. Chan领导一项研究发表在《 JAMA肿瘤学》之上。研究人员对两项美国大型队列研究进行了汇总分析，这两项研究提供了约35,500名参与者在过去35年中使用阿司匹林的数据，为了解阿司匹林对癌症风险的影响提供了独特的机会。

研究人员发现，常规使用阿司匹林与降低的结直肠癌风险有关。但是，这一优势仅在70岁之前开始服用阿司匹林的人群中才有意义。在70岁或70岁以上开始常规使用阿司匹林的人群似乎没有任何益处。

JGH OPEN：阿司匹林对胃癌的发生和生存的影响

JAMA Oncology：年轻时就开始使用阿司匹林，结直肠癌患病风险显著降低！

JAMA Netw Open：阿司匹林的使用与老年患者癌症发病率和生存率的评价

NEJM：5万人研究表明，“神药”阿司匹林或能预防肝癌

Lancet：柳叶刀新文巩固阿司匹林“神药”地位，服药两年可降低结直肠癌高危人群发病风险

Lancet Gastroen Hepatol：阿司匹林肿瘤辅助治疗的安全性评估

Clin Gastroenterology H：单用或联合氯吡格雷&低剂量阿司匹林可以降低结直肠癌的风险

PNAS：阿司匹林可刺激癌症的消退

JGH：低剂量阿司匹林可降低手术后结直肠癌的死亡率

JAMA Intern Med：阿司匹林或可防肝癌！分析中国人群15年的数据发现，长期服用阿司匹林与慢性乙肝患者肝癌风险降低29%相关

原始出处：

Guo CG, Ma W, Drew DA, Cao Y, Nguyen LH, Joshi AD, Ng K, Ogino S, Meyerhardt JA, Song M, Leung WK, Giovannucci EL, Chan AT. Aspirin Use and Risk of Colorectal Cancer Among Older Adults.JAMA Oncol. 2021 Jan 21. doi: 10.1001/jamaoncol.2020.7338.

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2021-03-13 docwu2019

#癌风险#

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2021-10-13 circumcision

#Oncology#

30 0
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2021-08-10 lfyang

#结直肠癌风险#

46 0
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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-10-17 minlingfeng

#Oncol#

33 0
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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-01-29 精气神

有待考证

69 0
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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-01-25 crystal0564

#结直肠#

35 0
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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-01-23 旺医

顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

61 0
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createdBy=cb7226973259, createdName=circumcision, createdTime=Wed Oct 13 03:18:04 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705377, encodeId=49871e05377d4, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue Aug 10 14:18:04 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865985, encodeId=690318659853b, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sun Oct 17 23:18:04 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921033, encodeId=663f92103325, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/11/07/32f6eeca95f16df602e2fe81e7416090.jpg, createdBy=ddb32421444, createdName=精气神, createdTime=Fri Jan 29 13:50:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453460, encodeId=34621453460ff, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Jan 25 09:18:04 CST 2021, time=2021-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036414, encodeId=349e103641425, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038188, encodeId=544810381883a, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-01-23 anti-cancer

谢谢梅斯分享这么多精彩信息

60 0
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createdBy=cb7226973259, createdName=circumcision, createdTime=Wed Oct 13 03:18:04 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705377, encodeId=49871e05377d4, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue Aug 10 14:18:04 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865985, encodeId=690318659853b, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sun Oct 17 23:18:04 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921033, encodeId=663f92103325, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/11/07/32f6eeca95f16df602e2fe81e7416090.jpg, createdBy=ddb32421444, createdName=精气神, createdTime=Fri Jan 29 13:50:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453460, encodeId=34621453460ff, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Jan 25 09:18:04 CST 2021, time=2021-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036414, encodeId=349e103641425, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038188, encodeId=544810381883a, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-01-23 ms2000001051330459

学习了，涨知识了！

71 0
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createdBy=cb7226973259, createdName=circumcision, createdTime=Wed Oct 13 03:18:04 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705377, encodeId=49871e05377d4, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue Aug 10 14:18:04 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865985, encodeId=690318659853b, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, 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likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Jan 25 09:18:04 CST 2021, time=2021-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036414, encodeId=349e103641425, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038188, encodeId=544810381883a, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Jan 23 21:18:04 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919273, encodeId=de8d9192e397, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sat Jan 23 19:47:28 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919271, encodeId=5d9f9192e117, content=有待考证, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65c55455166, createdName=ms7000001087860977, createdTime=Sat Jan 23 19:46:33 CST 2021, time=2021-01-23, status=1, ipAttribution=)]
2021-01-23 ms7000001087860977

有待考证

79 0

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