title: Systematic assessment of pharmaceutical prescriptions in association with cancer risk: a method to conduct a population-wide medication-wide longitudinal study.
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 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.
authors: Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck St, Boston, MA, 02115 USA.
authors: Chirag J
authors: CJ
authors: Patel
authors: Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Clinical Research Centre (CRC), building 28, floor 11, Jan Waldenströms gata 35, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors: Jianguang
authors: J
authors: Ji
authors: Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Clinical Research Centre (CRC), building 28, floor 11, Jan Waldenströms gata 35, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors: Jan
authors: J
authors: Sundquist
authors: Stanford Prevention Research Center, Department of Medicine, and Department of Health Research and Policy, Stanford University School of Medicine, 1265 Welch Road, Stanford, CA, 94305, USA.
authors: John P A
authors: JP
authors: Ioannidis
authors: Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Clinical Research Centre (CRC), building 28, floor 11, Jan Waldenströms gata 35, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors: Kristina
authors: K
authors: Sundquist
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D044382:Population Groups; D055553:Prescription Drugs / Q000009:adverse effects*; D012107:Research Design; D012307:Risk Factors; D055815:Young Adult
chemical_list: D055553:Prescription Drugs