Phosphodiesterase 5 inhibitors use and risk of conventional and serrated precursors of colorectal cancer
Menée à partir de données 2000-2010 de la cohorte "the Health Professionals Follow-Up Study" portant sur 18 123 hommes ayant réalisé au moins une coloscopie, cette étude analyse l'association entre une utilisation d'inhibiteurs de la phosphodiestérase 5 et le risque de lésions dentelées ou d'adénomes colorectaux
Background: Phosphodiesterase 5 (PDE5) inhibitors have been hypothesized to have chemoprotective effects in colorectal cancer (CRC). Current population-based epidemiologic evidence is, however, limited and inconsistent. Methods: Among 18,123 men in the Health Professionals Follow-up Study who had at least one lower gastrointestinal endoscopy, we evaluated the association between PDE5 inhibitors use and risk of conventional adenoma and serrated lesion between 2000 and 2010, adjusted for repeated observations and multiple risk factors. We stratified by erectile dysfunction (ED) to account for potential 'confounding by indication'. Results: We documented 2,595 conventional adenomas and 1,395 serrated lesion polyps during the follow-up period. Using people without ED as reference group, recent PDE5 inhibitors use at baseline was not associated with lower risk of conventional adenoma (ED with PDE5 inhibitors: odds ratio (OR)=1.08, 95% CI=0.92 to 1.26; ED without PDE5 inhibitors: OR=0.95, 95% CI=0.85 to 1.06), serrated lesions (ED with PDE5 inhibitors: OR=1.19, 95% CI=0.97 to 1.45; ED without PDE5 inhibitors: OR=1.03, 95% CI=0.89 to 1.19), or advanced conventional adenomas (ED with PDE5 inhibitors: OR=1.20, 95% CI=0.94 to 1.53; ED without PDE5 inhibitors: OR=0.95, 95% CI=0.79 to 1.14). No association was found for PDE5 inhibitors use ever before as well. Conclusions: We found no evidence of an association between PDE5 inhibitors use and risk of conventional and serrated precursors of CRC. Impact: We show that PDE5 inhibitors use is not associated with precursors of CRC adjusted for medical and lifestyle risk factors among a large population of men with ten years of follow-up.