한빛사 논문
Jihun Kang MD;1,∗, Su-Min Jeong MD2,3,∗, Dong Wook Shin MD, DrPH, MBA4,5,6,#, Mihee Cho MD, PhD;7, Jong Ho Cho MD, PhD8, Jehun Kim MD9
1Department of Family Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
2Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
3Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
4Supportive Care Center, Samsung Comprehensive Cancer Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
5Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
6Center for Clinical Epidemiology, SAIHST, Sungkyunkwan University, Seoul, Korea
7Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Seoul, Republic of Korea
8Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul, Korea
9Division of Pulmonology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, South Korea
*Contributed equally as first author
#Corresponding author
Abstract
Objectives
The aim of this study was to investigate the associations of aspirin, metformin, and statins with lung cancer risk and mortality using population-based nationwide cohort data.
Methods
This study included a total of 732,199 participants who had undergone a national health check-up in 2002–2003. Lung cancer incidence and mortality were identified using a registered lung cancer diagnosis code (ICD-10 code C34) and the Korean National Death Registry. The study participants were followed from January 1, 2004 to 31 December 2013. Medication exposure was defined by cumulative duration of use and cumulative defined daily dose (cDDD) per 2-year interval. To avoid immortal time bias, drug exposure was inserted as a time-dependent variable in Cox analysis, which evaluated the associations of these medications with lung cancer.
Results
Metformin use had protective association with lung cancer incidence (P’s-for-trend = 0.008) and mortality (P’s-for-trend <0.001) in a dose-response fashion, and these associations were prominent among participants with cDDD of metformin ≥ 547.5, compared with non-diabetic patients. Lung cancer mortality was dose-dependently reduced with the use of aspirin ([P’s-for-trends 0.046] and statin [P’s-for-trends <0.001]). Combined use of aspirin, statins and metformin showed more prominent protective associations with lung cancer risk and mortality.
Conclusion
Use of aspirin, metformin, and statins had independent protective associations with lung cancer mortality, and metformin had inverse association with lung cancer risk. Further studies are necessary to develop clinically applicable anticancer strategies of these drugs for the reduction of lung cancer and related mortality.
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