title: Long-term use of lithium and risk of colorectal adenocarcinoma: a nationwide case-control study.
abstract: BACKGROUND
  Lithium accumulates in the colon and inhibits the enzyme GSK-3β that possesses anti-carcinogenic effects. We therefore examined the association between lithium use and colorectal cancer risk in a nationwide study.
  
  
  METHODS
  We used the Danish Cancer Registry to identify all patients diagnosed with incident colorectal adenocarcinoma during 2000-2012 (n=36 248). Using a matched case-control approach, we estimated the association between long-term use (⩾5 years) of lithium and risk of colorectal adenocarcinoma using conditional logistic regression.
  
  
  RESULTS
  Long-term use of lithium was similar among cases (0.22%) and controls (0.20%), yielding an odds ratio of 1.13 (95% confidence interval (CI), 0.89-1.43) for colorectal adenocarcinoma. Dose-response, subgroup and other subanalyses returned neutral associations. However, ORs differed for colorectal subsites (proximal colon: 1.01 (95% CI, 0.66-1.55; distal colon: 1.52 (95% CI, 1.05-2.20); and rectum: 0.80 (95% CI, 0.50-1.30).
  
  
  CONCLUSIONS
  Lithium use was not associated with an overall increased risk of colorectal adenocarcinoma. The variation by subsite warrants further investigation.
authors: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, DK-5000 Odense, Denmark.
authors: Anton
authors: A
authors: Pottegård
authors: Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, DK-5000 Odense, Denmark.
authors: Zandra Nymand
authors: ZN
authors: Ennis
authors: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, DK-5000 Odense, Denmark.|Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, DK-5000 Odense, Denmark.
authors: Jesper
authors: J
authors: Hallas
authors: Department of Cardiovascular and Renal Research, University of Southern Denmark, DK-5000 Odense, Denmark.
authors: Boye L
authors: BL
authors: Jensen
authors: Department of Cardiovascular and Renal Research, University of Southern Denmark, DK-5000 Odense, Denmark.|Department of Pathology, Odense University Hospital, DK-5000 Odense, Denmark.
authors: Kirsten
authors: K
authors: Madsen
authors: Danish Cancer Society Research Center, Danish Cancer Society, DK-2100 Copenhagen, Denmark.
authors: Søren
authors: S
authors: Friis
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003106:Colon / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012007:Rectum / Q000473:pathology; D012307:Risk Factors; D013997:Time Factors
chemical_list: D018692:Antimanic Agents; D018020:Lithium Compounds