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Systematic assessment of pharmaceutical prescriptions in association with cancer risk : a method to conduct a population-wide medication-wide longitudinal study

Patel, Chirag J. LU ; Ji, Jianguang LU ; Sundquist, Jan LU ; Ioannidis, John P A and Sundquist, Kristina LU (2016) In Scientific Reports 6.
Abstract

It is a public health priority to identify the adverse and non-adverse associations between pharmaceutical medications and cancer. We search for and evaluate associations between all prescribed medications and longitudinal cancer risk in participants of the Swedish Cancer Register (N = 9,014,975). We associated 552 different medications with incident cancer risk (any, breast, colon, and prostate) during 5.5 years of follow-up (7/1/2005-12/31/2010) in two types of statistical models, time-to-event and case-crossover. After multiple hypotheses correction and replication, 141 (26%) drugs were associated with any cancer in a time-to-event analysis constraining drug exposure to 1 year before first cancer diagnosis and adjusting for history... (More)

It is a public health priority to identify the adverse and non-adverse associations between pharmaceutical medications and cancer. We search for and evaluate associations between all prescribed medications and longitudinal cancer risk in participants of the Swedish Cancer Register (N = 9,014,975). We associated 552 different medications with incident cancer risk (any, breast, colon, and prostate) during 5.5 years of follow-up (7/1/2005-12/31/2010) in two types of statistical models, time-to-event and case-crossover. After multiple hypotheses correction and replication, 141 (26%) drugs were associated with any cancer in a time-to-event analysis constraining drug exposure to 1 year before first cancer diagnosis and adjusting for history of medication use. In a case-crossover analysis, 36 drugs (7%) were associated with decreased cancer risk. 12 drugs were found in common in both analyses with concordant direction of association. We found 14, 10, 7% of all drugs associated with colon, prostate, and breast cancers in time-to-event models. We only found 1, 2%, and 0% for these cancers, respectively, in case-crossover analyses. Pharmacoepidemiologic analyses of cancer risk are sensitive to modeling choices and false-positive findings are a threat. Medication-wide analyses using different analytical models may help suggest consistent signals of increased cancer risk.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
6
publisher
Nature Publishing Group
external identifiers
  • scopus:84981719896
  • wos:000381107400001
ISSN
2045-2322
DOI
10.1038/srep31308
language
English
LU publication?
yes
id
4d4067d9-387f-4f2e-b124-3e064f34e8bb
date added to LUP
2016-12-07 12:18:15
date last changed
2017-01-01 08:42:19
@article{4d4067d9-387f-4f2e-b124-3e064f34e8bb,
  abstract     = {<p>It is a public health priority to identify the adverse and non-adverse associations between pharmaceutical medications and cancer. We search for and evaluate associations between all prescribed medications and longitudinal cancer risk in participants of the Swedish Cancer Register (N = 9,014,975). We associated 552 different medications with incident cancer risk (any, breast, colon, and prostate) during 5.5 years of follow-up (7/1/2005-12/31/2010) in two types of statistical models, time-to-event and case-crossover. After multiple hypotheses correction and replication, 141 (26%) drugs were associated with any cancer in a time-to-event analysis constraining drug exposure to 1 year before first cancer diagnosis and adjusting for history of medication use. In a case-crossover analysis, 36 drugs (7%) were associated with decreased cancer risk. 12 drugs were found in common in both analyses with concordant direction of association. We found 14, 10, 7% of all drugs associated with colon, prostate, and breast cancers in time-to-event models. We only found 1, 2%, and 0% for these cancers, respectively, in case-crossover analyses. Pharmacoepidemiologic analyses of cancer risk are sensitive to modeling choices and false-positive findings are a threat. Medication-wide analyses using different analytical models may help suggest consistent signals of increased cancer risk.</p>},
  articleno    = {31308},
  author       = {Patel, Chirag J. and Ji, Jianguang and Sundquist, Jan and Ioannidis, John P A and Sundquist, Kristina},
  issn         = {2045-2322},
  language     = {eng},
  month        = {08},
  publisher    = {Nature Publishing Group},
  series       = {Scientific Reports},
  title        = {Systematic assessment of pharmaceutical prescriptions in association with cancer risk : a method to conduct a population-wide medication-wide longitudinal study},
  url          = {http://dx.doi.org/10.1038/srep31308},
  volume       = {6},
  year         = {2016},
}