Incidence of Common Cancers in Users of Antimuscarinic Medications for Overactive Bladder: A Danish Nationwide Cohort Study

Jesper Hallas*, Andrea V. Margulis, Anton Pottegård, Nina S. Kristiansen, Willem J. Atsma, Kwame Appenteng, Stefan de Vogel, James A. Kaye, Susana Perez-Gutthann, Alejandro Arana

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

The purpose of this study was to estimate the incidence rate (IR) of 10 common cancers in new users of antimuscarinic overactive bladder (OAB) medications. We conducted a cohort study using data recorded in Danish registers for patients newly exposed to the OAB drugs, darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine or trospium in years 2004–2012, aged ≥18 years and without cancer before treatment initiation. We estimated IRs for each study cancer (bladder, breast, colorectal, lung, melanoma, non-Hodgkin lymphoma, pancreas, prostate, renal and uterine), standardised by age and sex and explored IR trends over time since treatment initiation. For all cancer analyses, only the first incident targeted cancer was considered. Of 72,917 patients (60% women; mean age at treatment start: 66 years), 3475 developed a study cancer during 259,072 person-years of follow-up. The most common study cancers were prostate (48.1% of study cancers in men), breast (40.0% of study cancers in women) and lung (15.4% of all study cancers). The overall standardised study cancer IR was 5.4 per 1000 person-years (95% confidence interval, 5.3–5.6); IRs were similar across individual OAB drugs. The standardised IRs for bladder and prostate cancers, which have symptoms in common with OAB, were highest in the first 6 months of treatment initiation and lower thereafter. In contrast, IRs for other study cancers were nearly constant during follow-up. Cancer IRs did not vary substantially by individual OAB drug. Protopathic bias is a plausible explanation for the higher rates of bladder and prostate cancers observed soon after starting OAB drug treatment.

OriginalsprogEngelsk
TidsskriftBasic & Clinical Pharmacology & Toxicology
Vol/bind122
Udgave nummer6
Sider (fra-til)612-619
ISSN1742-7835
DOI
StatusUdgivet - 2018

Fingeraftryk

Overactive Urinary Bladder
Muscarinic Antagonists
Cohort Studies
Incidence
Pharmaceutical Preparations
Drug therapy
Neoplasms
Oncology
Prostatic Neoplasms
Lung
Non-Hodgkin's Lymphoma
Prostate
Pancreas
Melanoma
Confidence Intervals

Citer dette

Hallas, Jesper ; Margulis, Andrea V. ; Pottegård, Anton ; Kristiansen, Nina S. ; Atsma, Willem J. ; Appenteng, Kwame ; de Vogel, Stefan ; Kaye, James A. ; Perez-Gutthann, Susana ; Arana, Alejandro. / Incidence of Common Cancers in Users of Antimuscarinic Medications for Overactive Bladder : A Danish Nationwide Cohort Study. I: Basic & Clinical Pharmacology & Toxicology. 2018 ; Bind 122, Nr. 6. s. 612-619.
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title = "Incidence of Common Cancers in Users of Antimuscarinic Medications for Overactive Bladder: A Danish Nationwide Cohort Study",
abstract = "The purpose of this study was to estimate the incidence rate (IR) of 10 common cancers in new users of antimuscarinic overactive bladder (OAB) medications. We conducted a cohort study using data recorded in Danish registers for patients newly exposed to the OAB drugs, darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine or trospium in years 2004–2012, aged ≥18 years and without cancer before treatment initiation. We estimated IRs for each study cancer (bladder, breast, colorectal, lung, melanoma, non-Hodgkin lymphoma, pancreas, prostate, renal and uterine), standardised by age and sex and explored IR trends over time since treatment initiation. For all cancer analyses, only the first incident targeted cancer was considered. Of 72,917 patients (60{\%} women; mean age at treatment start: 66 years), 3475 developed a study cancer during 259,072 person-years of follow-up. The most common study cancers were prostate (48.1{\%} of study cancers in men), breast (40.0{\%} of study cancers in women) and lung (15.4{\%} of all study cancers). The overall standardised study cancer IR was 5.4 per 1000 person-years (95{\%} confidence interval, 5.3–5.6); IRs were similar across individual OAB drugs. The standardised IRs for bladder and prostate cancers, which have symptoms in common with OAB, were highest in the first 6 months of treatment initiation and lower thereafter. In contrast, IRs for other study cancers were nearly constant during follow-up. Cancer IRs did not vary substantially by individual OAB drug. Protopathic bias is a plausible explanation for the higher rates of bladder and prostate cancers observed soon after starting OAB drug treatment.",
author = "Jesper Hallas and Margulis, {Andrea V.} and Anton Potteg{\aa}rd and Kristiansen, {Nina S.} and Atsma, {Willem J.} and Kwame Appenteng and {de Vogel}, Stefan and Kaye, {James A.} and Susana Perez-Gutthann and Alejandro Arana",
year = "2018",
doi = "10.1111/bcpt.12965",
language = "English",
volume = "122",
pages = "612--619",
journal = "Basic & Clinical Pharmacology & Toxicology",
issn = "1742-7835",
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Incidence of Common Cancers in Users of Antimuscarinic Medications for Overactive Bladder : A Danish Nationwide Cohort Study. / Hallas, Jesper; Margulis, Andrea V.; Pottegård, Anton; Kristiansen, Nina S.; Atsma, Willem J.; Appenteng, Kwame; de Vogel, Stefan; Kaye, James A.; Perez-Gutthann, Susana; Arana, Alejandro.

I: Basic & Clinical Pharmacology & Toxicology, Bind 122, Nr. 6, 2018, s. 612-619.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Incidence of Common Cancers in Users of Antimuscarinic Medications for Overactive Bladder

T2 - A Danish Nationwide Cohort Study

AU - Hallas, Jesper

AU - Margulis, Andrea V.

AU - Pottegård, Anton

AU - Kristiansen, Nina S.

AU - Atsma, Willem J.

AU - Appenteng, Kwame

AU - de Vogel, Stefan

AU - Kaye, James A.

AU - Perez-Gutthann, Susana

AU - Arana, Alejandro

PY - 2018

Y1 - 2018

N2 - The purpose of this study was to estimate the incidence rate (IR) of 10 common cancers in new users of antimuscarinic overactive bladder (OAB) medications. We conducted a cohort study using data recorded in Danish registers for patients newly exposed to the OAB drugs, darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine or trospium in years 2004–2012, aged ≥18 years and without cancer before treatment initiation. We estimated IRs for each study cancer (bladder, breast, colorectal, lung, melanoma, non-Hodgkin lymphoma, pancreas, prostate, renal and uterine), standardised by age and sex and explored IR trends over time since treatment initiation. For all cancer analyses, only the first incident targeted cancer was considered. Of 72,917 patients (60% women; mean age at treatment start: 66 years), 3475 developed a study cancer during 259,072 person-years of follow-up. The most common study cancers were prostate (48.1% of study cancers in men), breast (40.0% of study cancers in women) and lung (15.4% of all study cancers). The overall standardised study cancer IR was 5.4 per 1000 person-years (95% confidence interval, 5.3–5.6); IRs were similar across individual OAB drugs. The standardised IRs for bladder and prostate cancers, which have symptoms in common with OAB, were highest in the first 6 months of treatment initiation and lower thereafter. In contrast, IRs for other study cancers were nearly constant during follow-up. Cancer IRs did not vary substantially by individual OAB drug. Protopathic bias is a plausible explanation for the higher rates of bladder and prostate cancers observed soon after starting OAB drug treatment.

AB - The purpose of this study was to estimate the incidence rate (IR) of 10 common cancers in new users of antimuscarinic overactive bladder (OAB) medications. We conducted a cohort study using data recorded in Danish registers for patients newly exposed to the OAB drugs, darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine or trospium in years 2004–2012, aged ≥18 years and without cancer before treatment initiation. We estimated IRs for each study cancer (bladder, breast, colorectal, lung, melanoma, non-Hodgkin lymphoma, pancreas, prostate, renal and uterine), standardised by age and sex and explored IR trends over time since treatment initiation. For all cancer analyses, only the first incident targeted cancer was considered. Of 72,917 patients (60% women; mean age at treatment start: 66 years), 3475 developed a study cancer during 259,072 person-years of follow-up. The most common study cancers were prostate (48.1% of study cancers in men), breast (40.0% of study cancers in women) and lung (15.4% of all study cancers). The overall standardised study cancer IR was 5.4 per 1000 person-years (95% confidence interval, 5.3–5.6); IRs were similar across individual OAB drugs. The standardised IRs for bladder and prostate cancers, which have symptoms in common with OAB, were highest in the first 6 months of treatment initiation and lower thereafter. In contrast, IRs for other study cancers were nearly constant during follow-up. Cancer IRs did not vary substantially by individual OAB drug. Protopathic bias is a plausible explanation for the higher rates of bladder and prostate cancers observed soon after starting OAB drug treatment.

U2 - 10.1111/bcpt.12965

DO - 10.1111/bcpt.12965

M3 - Journal article

C2 - 29345103

AN - SCOPUS:85046533768

VL - 122

SP - 612

EP - 619

JO - Basic & Clinical Pharmacology & Toxicology

JF - Basic & Clinical Pharmacology & Toxicology

SN - 1742-7835

IS - 6

ER -