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Pancreatic cancer is associated with medication changes prior to clinical diagnosis

Zhang, Yin ; Wang, Qiao-Li LU orcid ; Yuan, Chen ; Lee, Alice A ; Babic, Ana ; Ng, Kimmie ; Perez, Kimberly ; Nowak, Jonathan A ; Lagergren, Jesper and Stampfer, Meir J , et al. (2023) In Nature Communications 14(1).
Abstract

Patients with pancreatic ductal adenocarcinoma (PDAC) commonly develop symptoms and signs in the 1-2 years before diagnosis that can result in changes to medications. We investigate recent medication changes and PDAC diagnosis in Nurses' Health Study (NHS; females) and Health Professionals Follow-up Study (HPFS; males), including up to 148,973 U.S. participants followed for 2,994,057 person-years and 991 incident PDAC cases. Here we show recent initiation of antidiabetic (NHS) or anticoagulant (NHS, HFS) medications and cessation of antihypertensive medications (NHS, HPFS) are associated with pancreatic cancer diagnosis in the next 2 years. Two-year PDAC risk increases as number of relevant medication changes increases (P-trend <1 ×... (More)

Patients with pancreatic ductal adenocarcinoma (PDAC) commonly develop symptoms and signs in the 1-2 years before diagnosis that can result in changes to medications. We investigate recent medication changes and PDAC diagnosis in Nurses' Health Study (NHS; females) and Health Professionals Follow-up Study (HPFS; males), including up to 148,973 U.S. participants followed for 2,994,057 person-years and 991 incident PDAC cases. Here we show recent initiation of antidiabetic (NHS) or anticoagulant (NHS, HFS) medications and cessation of antihypertensive medications (NHS, HPFS) are associated with pancreatic cancer diagnosis in the next 2 years. Two-year PDAC risk increases as number of relevant medication changes increases (P-trend <1 × 10-5), with participants who recently start antidiabetic and stop antihypertensive medications having multivariable-adjusted hazard ratio of 4.86 (95%CI, 1.74-13.6). These changes are not associated with diagnosis of other digestive system cancers. Recent medication changes should be considered as candidate features in multi-factor risk models for PDAC, though they are not causally implicated in development of PDAC.

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publishing date
type
Contribution to journal
publication status
published
keywords
Male, Female, Humans, Follow-Up Studies, Antihypertensive Agents/therapeutic use, Pancreatic Neoplasms/diagnosis, Carcinoma, Pancreatic Ductal/diagnosis, Hypoglycemic Agents/therapeutic use
in
Nature Communications
volume
14
issue
1
article number
2437
publisher
Nature Publishing Group
external identifiers
  • scopus:85156203951
  • pmid:37117188
ISSN
2041-1723
DOI
10.1038/s41467-023-38088-2
language
English
LU publication?
no
additional info
© 2023. The Author(s).
id
c889a616-9dea-48e7-8d9b-f8d30571a4c2
date added to LUP
2025-05-12 17:10:29
date last changed
2025-07-08 09:54:02
@article{c889a616-9dea-48e7-8d9b-f8d30571a4c2,
  abstract     = {{<p>Patients with pancreatic ductal adenocarcinoma (PDAC) commonly develop symptoms and signs in the 1-2 years before diagnosis that can result in changes to medications. We investigate recent medication changes and PDAC diagnosis in Nurses' Health Study (NHS; females) and Health Professionals Follow-up Study (HPFS; males), including up to 148,973 U.S. participants followed for 2,994,057 person-years and 991 incident PDAC cases. Here we show recent initiation of antidiabetic (NHS) or anticoagulant (NHS, HFS) medications and cessation of antihypertensive medications (NHS, HPFS) are associated with pancreatic cancer diagnosis in the next 2 years. Two-year PDAC risk increases as number of relevant medication changes increases (P-trend &lt;1 × 10-5), with participants who recently start antidiabetic and stop antihypertensive medications having multivariable-adjusted hazard ratio of 4.86 (95%CI, 1.74-13.6). These changes are not associated with diagnosis of other digestive system cancers. Recent medication changes should be considered as candidate features in multi-factor risk models for PDAC, though they are not causally implicated in development of PDAC.</p>}},
  author       = {{Zhang, Yin and Wang, Qiao-Li and Yuan, Chen and Lee, Alice A and Babic, Ana and Ng, Kimmie and Perez, Kimberly and Nowak, Jonathan A and Lagergren, Jesper and Stampfer, Meir J and Giovannucci, Edward L and Sander, Chris and Rosenthal, Michael H and Kraft, Peter and Wolpin, Brian M}},
  issn         = {{2041-1723}},
  keywords     = {{Male; Female; Humans; Follow-Up Studies; Antihypertensive Agents/therapeutic use; Pancreatic Neoplasms/diagnosis; Carcinoma, Pancreatic Ductal/diagnosis; Hypoglycemic Agents/therapeutic use}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Nature Communications}},
  title        = {{Pancreatic cancer is associated with medication changes prior to clinical diagnosis}},
  url          = {{http://dx.doi.org/10.1038/s41467-023-38088-2}},
  doi          = {{10.1038/s41467-023-38088-2}},
  volume       = {{14}},
  year         = {{2023}},
}