USE OF ANTIPSYCHOTICS AND THE RISK OF COLORECTAL CANCER- A CASE-CONTROL STUDY USING DATA FROM THE LINKED NETHERLANDS CANCER REGISTRY AND PHARMO DATABASE NETWORK POPULATION
Author(s)
Kuiper JG1, van Herk-Sukel MP2, Lemmens VE3, Herings RM4
1Erasmus University Medical Center, Rotterdam, The Netherlands, 2University Medical Center Utrecht, Utrecht, The Netherlands, 3Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands, 4PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
OBJECTIVES: The carcinogenetic effects of antipsychotics is unclear and may vary between different types of antipsychotics. Therefore, this study examines the association between the use of different types of antipsychotics and the risk of colorectal cancer (CRC) using data from the linkage between the Netherlands Cancer Registry (NCR) and Out-patient Pharmacy Database of the PHARMO Database Network. METHODS: Patients who were newly diagnosed with CRC between 1998-2014 were selected. The date of diagnosis was defined as index date. Each patient was matched to four controls based on gender, birth year and year of start enrolment in the PHARMO Database Network. Matched controls received the same index date as their matched case. Cases and controls were not allowed to have a diagnosis of cancer before index date. The association between the use of antipsychotics (either typical, atypical or lithium) before index date and risk of CRC was estimated using conditional logistic regression. RESULTS: A total of 29,490 CRC cases and 117,960 controls were identified. The use of any antipsychotic before index date was slightly higher among controls compared to CRC cases [3% vs. 2%] resulted in an odds ratio (OR) of 0.64 (95% CI 0.59-0.70) for CRC. Stratification by typical or atypical antipsychotics yielded almost the same OR. A different OR was seen for lithium: 1.17 (95% CI: 0.94-1.45) and increased with long term use [≥5 years: 1.60 (95% CI: 1.12-2.31). Also, the OR of lithium differed between tumour sites: [proximal colon: 1.09 (95% CI: 0.78-1.53); distal colon: 1.44 (95% CI: 1.00-2.08) and rectum: 1.04 (95% CI: 0.65-1.65)], which was not seen for atypical or typical antipsychotics. CONCLUSIONS: Overall, no association was seen between the use of antipsychotics and the risk of CRC. However, an increased risk of CRC was seen with long term lithium use and differed between specific tumour sites.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN49
Topic
Epidemiology & Public Health
Disease
Oncology