A growing proportion of children and adults take medication regularly, yet relatively few drugs have undergone adequate post-marketing surveillance for adverse effects, including elevated cancer rates. The main objective of this study is to identify drugs that are associated with lower or higher rates of cancer and examine whether these associations deserve further study. The proposed research builds on a drug surveillance program conducted within the Kaiser Permanente health plan over the last 30 years. Specifically, we propose to: 1) Continue surveillance of the 200 most commonly used prescription drugs for possible carcinogenic effects will be conducted among the entire KPMCP membership, about 3 million persons, starting, in part, in 1991. Cancer incidence among users of specific medications or groups of medications will be compared with those expected, based on rates in entire KPMCP membership. 2) Conduct pilot case-control studies of selected drug-cancer associations found in the above screening analyses will be conducted to determine whether the associations are likely due to confounding and, if not, whether there is evidence of a dose-response effect, or evidence against biological plausibility. The Kaiser Permanente membership and databases provide a unique resource for studying potential drug-cancer associations. The membership is large (3.1 million), stable, ethnically diverse, and receives virtually all of its health care from the pre-paid, integrated medical care program. Each year approximately 20 million prescriptions are dispensed to health plan members. The proposed research will provide a valuable mechanism to identify early signs of possible carcinogenic effects of the most commonly used medications or reassurance as to their safety in this regard.
| Bradley, Marie C; Ferrara, Assiamira; Achacoso, Ninah et al. (2018) A Cohort Study of Metformin and Colorectal Cancer Risk among Patients with Diabetes Mellitus. Cancer Epidemiol Biomarkers Prev 27:525-530 |
| Banegas, Matthew P; Emerson, Marc A; Adams, Alyce S et al. (2018) Patterns of medication adherence in a multi-ethnic cohort of prevalent statin users diagnosed with breast, prostate, or colorectal cancer. J Cancer Surviv 12:794-802 |
| Su, K A; Habel, L A; Achacoso, N S et al. (2018) Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma. Br J Dermatol 179:1088-1094 |
| Emerson, Marc A; Banegas, Matthew P; Chawla, Neetu et al. (2017) Disparities in Prostate, Lung, Breast, and Colorectal Cancer Survival and Comorbidity Status among Urban American Indians and Alaskan Natives. Cancer Res 77:6770-6776 |
| Friedman, Gary D; Achacoso, Ninah; Fireman, Bruce et al. (2016) Statins and Reduced Risk of Liver Cancer: Evidence for Confounding. J Natl Cancer Inst 108: |
| Pottegård, Anton; Schmidt, Sigrún Alba Johannesdottir; Olesen, Anne Braae et al. (2016) Use of sildenafil or other phosphodiesterase inhibitors and risk of melanoma. Br J Cancer 115:895-900 |
| Sakoda, Lori C; Ferrara, Assiamira; Achacoso, Ninah S et al. (2015) Metformin use and lung cancer risk in patients with diabetes. Cancer Prev Res (Phila) 8:174-9 |
| Friedman, Gary D; Schwalbe, Joan; Achacoso, Ninah et al. (2014) Antidepressants and testicular cancer. Cancer Causes Control 25:251-8 |
| Kurian, Allison W; Lichtensztajn, Daphne Y; Keegan, Theresa H M et al. (2013) Patterns and predictors of breast cancer chemotherapy use in Kaiser Permanente Northern California, 2004-2007. Breast Cancer Res Treat 137:247-60 |
| Irizarry, Michael C; Webb, David J; Boudiaf, Nada et al. (2012) Risk of cancer in patients exposed to gabapentin in two electronic medical record systems. Pharmacoepidemiol Drug Saf 21:214-25 |
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