scholarly journals Risk of Cancer Following the Use of N-Nitrosodimethylamine (NDMA) Contaminated Ranitidine Products: A Nationwide Cohort Study in South Korea

2021 ◽  
Vol 10 (1) ◽  
pp. 153
Author(s):  
Hong Jin Yoon ◽  
Jie-Hyun Kim ◽  
Gi Hyeon Seo ◽  
Hyojin Park
Keyword(s):  
Cohort Study ◽  
Cancer Risk ◽  
South Korea ◽  
Primary Study ◽  
Study Cohort ◽  
Matched Cohort ◽  
Cancer Outcomes ◽  
H2 Receptor Antagonist ◽  
Carcinogenic Agent ◽  
Risk Of Cancer

N-nitrosodimethylamine (NDMA), a known carcinogenic agent, was recently detected in some products of ranitidine. Several studies have investigated the detectability of NDMA, in drugs and their risks. However, only a few epidemiological studies have evaluated cancer risk from the use of such individual drugs. This study investigates the risk of cancer in ranitidine users. We conducted an observational population-based cohort study using the Health Insurance Review and Assessment databases, which contain information about the use of medicines in South Korea. The primary study cohort consisted of ranitidine users (n = 88,416). For controls, we enrolled users of famotidine, another H2-receptor antagonist in which no NDMA has been detected. A 4:1 matched cohort was constructed to compare cancer outcomes of the two groups. Our matched cohort comprised of 40,488 ranitidine users and 10,122 famotidine users. There was no statistical difference in the overall cancer risk between the ranitidine and famotidine groups (7.45% vs. 7.56%, HR 0.99, 95% CI 0.91–1.07, p = 0.716). Additionally, no significant differences were observed in the analysis of 11 single cancer outcomes. We found no evidence that exposure to NDMA through ranitidine increases the risk of cancer.

scholarly journals Use of N-nitrosodimethylamine (NDMA) contaminated valsartan products and risk of cancer: Danish nationwide cohort study

BMJ ◽  
2018 ◽  
pp. k3851 ◽  
Author(s):  
Anton Pottegård ◽  
Kasper Bruun Kristensen ◽  
Martin Thomsen Ernst ◽  
Nanna Borup Johansen ◽  
Pierre Quartarolo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Risk ◽  
Confidence Interval ◽  
Cox Regression ◽  
Uterine Cancer ◽  
Hazard Ratio ◽  
Cancer Outcomes ◽  
Single Cancer ◽  
One Year ◽  
Risk Of Cancer

AbstractObjectiveTo perform an expedited assessment of cancer risk associated with exposure to N-nitrosodimethylamine (NDMA) through contaminated valsartan products.DesignNationwide cohort study.SettingDanish health registries on individual level prescription drug use, cancer occurrence, and hospital diagnoses.Participants5150 Danish patients with no history of cancer, aged 40 years or older, and using valsartan at 1 January 2012 or initiating use between 1 January 2012 and 30 June 2017. Participants were followed from one year after cohort entry (lag time period) until experiencing a cancer outcome, death, migration, or end of study period (30 June 2018). Each participant’s exposure to NDMA (ever exposure and predefined categories of cumulative valsartan exposure) was mapped out as a time varying variable while also applying a one year lag.Main outcome measuresAssociation between NDMA exposure and a primary composite endpoint comprising all cancers except non-melanoma skin cancer, estimated using Cox regression. In supplementary analyses, the risk of individual cancers was determined.ResultsThe final cohort comprised 5150 people followed for a median of 4.6 years. In total, 3625 cohort participants contributed 7344 person years classified as unexposed to NDMA, and 3450 participants contributed 11 920 person years classified as ever exposed to NDMA. With 104 cancer outcomes among NDMA unexposed participants and 198 among exposed participants, the adjusted hazard ratio for overall cancer was 1.09 (95% confidence interval 0.85 to 1.41), with no evidence of a dose-response relation (P=0.70). For single cancer outcomes, increases in risk were observed for colorectal cancer (hazard ratio 1.46, 95% confidence interval 0.79 to 2.73) and for uterine cancer (1.81, 0.55 to 5.90), although with wide confidence intervals that included the null.ConclusionsThe results do not imply a markedly increased short term overall risk of cancer in users of valsartan contaminated with NDMA. However, uncertainty persists about single cancer outcomes, and studies with longer follow-up are needed to assess long term cancer risk.

scholarly journals DOP44 Cancer risk in a high-incidence inflammatory bowel disease population: a Faroese IBD cohort study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S081-S082
Author(s):  
J M M Midjord ◽  
A G Vang ◽  
T Hammer ◽  
J Burisch ◽  
K R Nielsen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Cancer Risk ◽  
Bowel Disease ◽  
Incidence Rates ◽  
Study Cohort ◽  
Background Population ◽  
Inflammatory Bowel ◽  
Risk Of Cancer

Abstract Background The association between inflammatory bowel disease and malignancy is still controversial despite many observational studies. The Faroese population exhibits the highest occurrence of inflammatory bowel disease (IBD) in the world. The aim of this study was to investigate the risk of cancer in Faroese IBD patients within the nationwide Faroese IBD cohort. Methods This was a nationwide cohort study of all IBD patients diagnosed in the Faroe Islands from 1960 to 2014. Clinical demographics and cancer diagnosis were retrieved from patient files and from the Faroese cancer registry. Patients were followed until the event of cancer, death or emigration. Patients diagnosed with cancer prior to the IBD diagnosis were excluded. Observed numbers of cancer were compared with expected numbers based on ASR(N) (Nordic age- and sex-specific incidence rates) from Nordcan, by multiplying ASR(N) with person-years and follow-up in the study cohort and presented as standardised incidence ratios (SIRs) with 95 % intervals (CIs). Results The cohort consisted of 664 incidence IBD patients. After excluding 12 patients with cancer prior to IBD diagnosis, 652 patients with a total follow-up length of 11 476 person-years were included (414 UC with 7.494 patient-years, 128 IBDU with 2.038 patient-years and 110 CD with 1.944 patient-years). A total of 56 patients developed cancer during the follow-up period compared with 39.2 expected cases in the background population. We observed no gender difference. In UC, 33 observed compared with 25.7 expected patients developed cancer (SIR 1.28; 95% CI, 0.88–1.80). In IBDU, 13 observed compared with 6.9 expected patients developed cancer (SIR 1.88; 95% CI 1.00–0.22). In CD, 10 cases were observed compared with 6.6 expected (SIR 1.51; 95% CI 0.73–2.79). The most common types of cancers observed are shown in Table 1. Conclusion In this nationwide cohort study, we found no overall risk of cancer in IBD patients in the geographic isolated Faroe Island. However, skin cancer occurred more than expected in IBDU patients. This finding needs to be investigated further including the influence of treatment on cancer risk.

scholarly journals The Risk of Newly Diagnosed Cancer in Patients with Rheumatoid Arthritis by TNF Inhibitor Use: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Boyoon Choi ◽  
Hyun Jin Park ◽  
Yun-Kyoung Song ◽  
Yoon-Jeong Oh ◽  
In-Wha Kim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cancer Risk ◽  
Cox Regression ◽  
Tnf Inhibitors ◽  
Tnf Inhibitor ◽  
Matched Cohort ◽  
Korean Patients ◽  
Study Results ◽  
The One ◽  
Risk Of Cancer

Abstract Background Tumor necrosis factor (TNF) inhibitors use in patients with rheumatoid arthritis (RA) has raised safety concerns about cancer risk, but study results remain controversial. This largest nationwide study to date compared cancer risk in TNF inhibitor users to non-biologic disease-modifying anti-rheumatic drug (nbDMARD) users in Korean patients with RA. Methods Data on all the eligible patients diagnosed with RA between 2005 and 2016 were retrieved from the Korean National Health Information Database. The one-to-one matched patients consisted of the matched cohort. The risks for developing all-type and site-specific cancers were estimated using incidence and incidence rate (IR) per 1,000 person-years. Adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using a Cox regression model. Results Of the 22,851 patients in the before matching cohort, 4,592 patients were included in the matched cohort. Treatment with TNF inhibitors was consistently associated with a lower risk of cancer than in the nbDMARD cohort (IR per 1,000 person-years, 6.5 vs. 15.6; adjusted HR, 0.379; 95% CI, 0.255–0.563). The adjusted HR (95% CI) was significantly lower in the TNF inhibitor cohort than the nbDMARD cohort for gastrointestinal cancer (0.432; 0.235–0.797), breast cancer (0.146; 0.045–0.474), and genitourinary cancer (0.220; 0.059–0.820). Conclusions The use of TNF inhibitors was associated with a lower cancer incidence in Korean patients with RA. A further study linking claims and clinical data is needed to confirm our results.

scholarly journals Red meat consumption is associated with an increased overall cancer risk: a prospective cohort study in Korea

2014 ◽  
Vol 112 (2) ◽  
pp. 238-247 ◽  
Author(s):  
Gyung-Ah Wie ◽  
Yeong-Ah Cho ◽  
Hyun-hee Kang ◽  
Kyoung-A Ryu ◽  
Min-Kyoung Yoo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Research ◽  
Cohort Study ◽  
Cancer Risk ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Meat Consumption ◽  
Red Meat ◽  
Dietary Factors ◽  
Risk Of Cancer

Cancer is a leading cause of death, and the dietary pattern in Korea is changing rapidly from a traditional Korean diet to a Westernised diet. In the present study, we investigated the effects of dietary factors on cancer risk with a prospective cohort study. Among 26 815 individuals who participated in cancer screening examinations from September 2004 to December 2008, 8024 subjects who completed a self-administered questionnaire concerning demographic and lifestyle factors, and a 3 d food record were selected. As of September 2013, 387 cancer cases were identified from the National Cancer Registry System, and the remaining individuals were included in the control group. The hazard ratio (HR) of cancer for the subjects older than or equal to 50 years of age was higher (HR 1·80, 95 % CI 1·41, 2·31; P< 0·0001) than that for the other subjects. Red meat consumption, Na intake and obesity (BMI ≥ 25 kg/m2) were positively associated with overall cancer incidence in men (HR 1·41, 95 % CI 1·02, 1·94; P= 0·0382), gastric cancer (HR 2·34, 95 % CI 1·06, 5·19; P= 0·0365) and thyroid cancer (HR 1·56, 95 % CI 1·05, 2·31; P= 0·0270), respectively. Participants who had at least three dietary risk factors among the high intakes of red meat and Na, low intakes of vegetables and fruits, and obesity suggested by the World Cancer Research Fund/American Institute for Cancer Research at baseline tended to have a higher risk of cancer than the others (HR 1·26, 95 % CI 0·99, 1·60; P= 0·0653). In summary, high intakes of red meat and Na were significant risk factors of cancer among Koreans.

A Matched Cohort Study of the Risk of Cancer in Users of Becaplermin

2011 ◽  
Vol 24 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Najat Ziyadeh ◽  
Daniel Fife ◽  
Alexander M. Walker ◽  
Gregg S. Wilkinson ◽  
John D. Seeger
Keyword(s):  
Cohort Study ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Risk Of Cancer

scholarly journals Lipid biomarkers and Cancer risk - a population-based prospective cohort study in Taiwan

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu-Chen Chang ◽  
Chien-Ju Lin ◽  
Tzu-Lin Yeh ◽  
Ming-Chieh Tsai ◽  
Le-Yin Hsu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Risk ◽  
Cancer Incidence ◽  
Prospective Cohort ◽  
Blood Lipids ◽  
Density Lipoprotein ◽  
Lipid Levels ◽  
Lower Baseline ◽  
Risk Of Cancer ◽  
Baseline Total Cholesterol

Abstract Background Blood lipids are essential components for cellular growth. An inverse association between serum lipid levels and risk of cancer has led to a controversy among previous studies. The aim of this prospective cohort study was to investigate the association between blood lipids change and risk of cancer incidence. Methods A cohort of 4130 Taiwanese adults from the Taiwanese Survey on the Prevalence of Hypertension, Hyperglycemia, and Hyperlipidemia database underwent repeated examinations in 2002 and 2007. Six groups were established based on the combined baseline (lower/higher) and interval change (decreasing/stable/increasing) in plasma lipid levels. Multivariable Cox proportional hazard model was used to investigate the relationship between lipids change and all-cause cancer incidence. Results Two hundred and forty cancer events developed over a median follow-up of 13.4 years. Comparing these with individuals with decreasing lower-baseline lipid levels, cancer risk reduction was demonstrated in those with increasing lower-baseline total cholesterol (adjusted hazard ratio [aHR], 0.48; 95% confidence interval [CI], 0.27 to 0.85), low-density lipoprotein cholesterol (LDL-C; aHR, 0.56; 95% CI, 0.35 to 0.92), and non–high-density lipoprotein cholesterol (non-HDL-C) (aHR, 0.54; 95% CI, 0.31 to 0.92) levels. A decreased risk for cancer incidence also presented in participants with stable lower-baseline, decreasing and increasing higher-baseline LDL-C levels, and with decreasing and stable higher-baseline non-HDL-C levels. Conclusions The interval decline in lower-baseline total cholesterol, LDL-C, and non-HDL-C levels was linked to a higher risk for all-cause cancer incidence. More attention to a potential cancer risk may be warranted for an unexplained fall in serum lipids.

scholarly journals Cancer risk in individuals with intellectual disability in Sweden: A population-based cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (10) ◽  
pp. e1003840
Author(s):  
Qianwei Liu ◽  
Hans-Olov Adami ◽  
Abraham Reichenberg ◽  
Alexander Kolevzon ◽  
Fang Fang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intellectual Disability ◽  
Cancer Risk ◽  
Reference Group ◽  
Population Based ◽  
Sibling Comparison ◽  
Increased Risk ◽  
Specific Cancer ◽  
Cancer Types ◽  
Risk Of Cancer

Background A knowledge gap exists about the risk of cancer in individuals with intellectual disability (ID). The primary aim of this study was to estimate the cancer risk among individuals with ID compared to individuals without ID. Methods and findings We conducted a population-based cohort study of all children live-born in Sweden between 1974 and 2013 and whose mothers were born in a Nordic country. All individuals were followed from birth until cancer diagnosis, emigration, death, or 31 December 2016 (up to age 43 years), whichever came first. Incident cancers were identified from the Swedish Cancer Register. We fitted Cox regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) as measures of cancer risk in relation to ID after adjusting for several potential confounders. We analyzed ID by severity, as well as idiopathic ID and syndromic ID separately. We performed a sibling comparison to investigate familial confounding. The study cohort included a total of 3,531,305 individuals, including 27,956 (0.8%) individuals diagnosed with ID. Compared with the reference group (individuals without ID and without a full sibling with ID), individuals with ID were in general more likely to be male. The median follow-up time was 8.9 and 23.0 years for individuals with ID and individuals without ID, respectively. A total of 188 cancer cases were identified among individuals with ID (incidence rate [IR], 62 per 1,000 person-years), and 24,960 among individuals in the reference group (IR, 31 per 1,000 person-years). A statistically significantly increased risk was observed for any cancer (HR 1.57, 95% CI 1.35–1.82; P < 0.001), as well as for several cancer types, including cancers of the esophagus (HR 28.4, 95% CI 6.2–130.6; P < 0.001), stomach (HR 6.1, 95% CI 1.5–24.9; P = 0.013), small intestine (HR 12.0, 95% CI 2.9–50.1; P < 0.001), colon (HR 2.0, 95% CI 1.0–4.1; P = 0.045), pancreas (HR 6.0, 95% CI 1.5–24.8; P = 0.013), uterus (HR 11.7, 95% CI 1.5–90.7; P = 0.019), kidney (HR 4.4, 95% CI 2.0–9.8; P < 0.001), central nervous system (HR 2.7, 95% CI 2.0–3.7; P < 0.001), and other or unspecified sites (HR 4.8, 95% CI 1.8–12.9; P = 0.002), as well as acute lymphoid leukemia (HR 2.4, 95% CI 1.3–4.4; P = 0.003) and acute myeloid leukemia (HR 3.0, 95% CI 1.4–6.4; P = 0.004). Cancer risk was not modified by ID severity or sex but was higher for syndromic ID. The sibling comparison showed little support for familial confounding. The main study limitations were the limited statistical power for the analyses of specific cancer types, and the potential for underestimation of the studied associations (e.g., due to potential underdetection or delayed diagnosis of cancer among individuals with ID). Conclusions In this study, we found that individuals with ID showed an increased risk of any cancer, as well as of several specific cancer types. These findings suggest that extended surveillance and early intervention for cancer among individuals with ID are warranted.

scholarly journals Use of lithium and cancer risk in patients with bipolar disorder: population-based cohort study

2016 ◽  
Vol 209 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Ru-Yu Huang ◽  
Kun-Pin Hsieh ◽  
Wan-Wen Huang ◽  
Yi-Hsin Yang
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Cancer Risk ◽  
Cox Regression ◽  
Glycogen Synthase ◽  
Control Group ◽  
Defined Daily Dose ◽  
Research Database ◽  
Hazard Ratios ◽  
Risk Of Cancer

BackgroundLithium inhibits glycogen synthase kinase-3, which is an enzyme involved in the pathogenesis of cancer.AimsTo investigate the association between lithium and cancer risk in patients with bipolar disorder.MethodA retrospective cohort study was designed using the National Health Insurance Research Database (NHIRD) in Taiwan. Patients using lithium comprised the index drug group and patients using anticonvulsants only comprised the control group. Time-dependent Cox regression was used to evaluate the hazard ratios (HRs) for risk of cancer.ResultsCompared with anticonvulsant-only exposure, lithium exposure was associated with significantly lower cancer risk (HR = 0.735, 95% CI 0.554–0.974). The hazard ratios for the first, second and third tertiles of the cumulative defined daily dose were 0.762 (95% CI 0.516–1.125), 0.919 (95% CI 0.640–1.318) and 0.552 (95% CI 0.367–0.831), respectively.ConclusionsLithium is associated with reduced overall cancer risk in patients with bipolar disorder. A dose–response relationship for cancer risk reduction was observed.

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