Acetaminophen, Some other Drugs, Some Diseases and the Risk of Transitional Cell Carcinoma: A population-based case-control study

Steineck, Gunnar; Be, Wiholm; M, Gerhardsson de Verdier

doi:10.3109/02841869509127181

Cited by 38 publications

(30 citation statements)

References 25 publications

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“…In the largest study of renal pelvis and ureter cancer to date, 12 no association with paracetamol use was seen. Of 6 case-control studies that examined use of paracetamol in relation to cancer of the urinary bladder, only the study by Steineck et al 11 found an increased risk. These authors reported a significantly increased risk for transitional cell cancer among all users of paracetamol (OR, 1.6; 95% CI, 1.1-2.3), with the highest risk among users of paracetamol not exposed to aspirin (OR, 2.1; 95% CI, 0.7-6.6).…”

Section: Discussionmentioning

confidence: 99%

Cancer risk in persons receiving prescriptions for paracetamol: A Danish cohort study

Friis

Nielsen

Mellemkjær

et al. 2001

Intl Journal of Cancer

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The use of paracetamol has been associated with increased risks for urinary tract cancers and decreased risk for ovarian cancer, although results have been inconsistent. We conducted a population-based cohort study using data from the Prescription Database of North Jutland County and the Danish Cancer Registry. Cancer incidence among 39,946 individuals receiving prescriptions for paracetamol was compared with expected incidence based on the North Jutland population who did not receive paracetamol prescriptions, during a 9-year follow-up period. Standardized incidence ratios (SIRs) with corresponding 95% confidence intervals (95% CIs) were calculated for cancers overall and at selected sites. Overall, 2,173 cancers were observed with 1,973 expected, yielding a SIR of 1.10 (95% CI, 1.06 -1.15). Significantly elevated SIRs were found for cancers of the esophagus (1.9; 95% CI, 1.3-2.8) and lung (1.6; 95% CI, 1.4 -1.7). Nonsignificantly increased SIRs were observed for cancers of the liver (1.5; 95% CI, 0.96 -2.2), renal parenchyma (1.3; 95% CI, 0.9 -1.7) and renal pelvis/ureter (1.6; 95% CI, 0.96 -2.6), whereas the SIR for cancer of the urinary bladder was close to unity (1.1; 95% CI, 0.9 -1.4). For ovarian cancer, the SIR was close to expectation (0.9; 95% CI, 0.6 -1.2) with no evidence of trends with duration of follow-up or number of prescriptions. A similar risk pattern was observed after exclusion of person-time experience following prescription for aspirin or other nonsteroidal antiinflammatory drugs in the study cohort and reference population. Our results do not support a major role for paracetamol in the development of cancers of the urinary tract, and we found little evidence of a protective effect of paracetamol against ovarian cancer. The elevated risks for cancers of the esophagus, lung and liver are most likely a result of confounding variables, but may warrant further investigation.

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Section: Discussionmentioning

confidence: 99%

Cancer risk in persons receiving prescriptions for paracetamol: A Danish cohort study

Friis

Nielsen

Mellemkjær

et al. 2001

Intl Journal of Cancer

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“…21,33 Individuals who were in the highest tertile of lifetime consumption of aspirin compared to individuals in the lowest tertile had approximately a 40 and 50% reduction in bladder cancer risk among nonexclusive users (RR 5 0.63, 95% CI: 0.43-0.92) and exclusive users (RR 5 0.49, 95% CI: 0.29-0.84), respectively, 21 while a 30% reduction in risk was observed for aspirin use in the study in Sweden. 33 Compared to the previous case-control investigations of analgesic use and bladder cancer risk, our analysis used prospective data, where analgesic use is measured prior to the development of disease. Although recall bias was not an issue in our study, men who were diagnosed with bladder cancer soon after completion of the questionnaire may have increased their analgesic use because of prediagnostic disease signs and symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…37,38,[40][41][42][43] Additionally, animal studies have shown that acetaminophen can induce urinary bladder carcinomas in rats 44 and mice. 45 However, no associations have been reported between acetaminophen and bladder cancer risk in most, 21,39,46,47 but not all, 33 observational studies.…”

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confidence: 99%

“…30,31 Four case-control studies on aspirin use and bladder cancer risk have reported inconsistent results. 21,[32][33][34] Two case-control studies reported a 30-50% lower risk of bladder cancer with regular aspirin intake. 21,33 In contrast, a statistically nonsignificant positive association was observed between regular aspirin use and risk of bladder cancer in men in a third study, 32 and no association was observed in a fourth study on regular aspirin use.…”

mentioning

confidence: 99%

“…21,[32][33][34] Two case-control studies reported a 30-50% lower risk of bladder cancer with regular aspirin intake. 21,33 In contrast, a statistically nonsignificant positive association was observed between regular aspirin use and risk of bladder cancer in men in a third study, 32 and no association was observed in a fourth study on regular aspirin use. 34 In one prospective study conducted in NHANES I and NHANES II, aspirin use was associated with a statistically significant greater risk of bladder cancer mortality in women, although case numbers for women were small (N 5 15).…”

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confidence: 99%

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Nonsteroidal antiinflammatory drug use and risk of bladder cancer in the health professionals follow‐up study

Genkinger

DeVivo

Stampfer

et al. 2007

Intl Journal of Cancer

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Nonsteroidal antiinflammatory drugs (NSAIDs) use, particularly aspirin, may lower the risk of several cancers, including bladder. NSAIDs may reduce development of bladder tumors by decreasing inflammation, inhibiting cycloxygenase-2, inhibiting proliferation and inducing apoptosis of cancer cells. However, acetaminophen, a major metabolite of phenacetin, may be positively associated with bladder cancer risk. Results from case-control studies on NSAIDs and acetaminophen use and bladder cancer risk are inconsistent. We investigated the association between NSAID and acetaminophen use and bladder cancer risk in a large cohort of US males. Among 49,448 men in the Health Professionals FollowUp Study, 607 bladder cancer cases were confirmed during 18 years of follow-up. Relative risks (RR) and 95% confidence intervals (CI) were calculated by Cox proportional hazards models. Multivariate RR were adjusted for age, current smoking status, pack years, geographic region and fluid intake. No significant associations were observed for regular aspirin ( 2 tablets per week), (RR 5 0.99, 95% CI 0.83-1.18), ibuprofen (RR 5 1.11, 95% CI 0.81-1.54), acetaminophen (RR 5 0.96, 95% CI 0.67-1.39) or total NSAID use (not including acetaminophen; RR 5 1.01, 95% CI 0.85-1.20) and bladder cancer risk compared with nonuse. Consistent use (over 6 years) of aspirin, ibuprofen, acetaminophen and total NSAIDs, compared to nonuse, was not associated with bladder cancer risk. No association was observed between aspirin frequency and dose and bladder cancer risk. We observed no effect-modification by smoking, age or fluid intake. Our results suggest that regular NSAID or acetaminophen use has no substantial impact on bladder cancer risk among men. ' 2007 Wiley-Liss, Inc.Key words: bladder cancer; NSAID use; epidemiology; cohort In the US, bladder cancer is the fourth most common cause of cancer among men and the ninth most common cause of cancer death among men. 1 Bladder cancer is approximately 2-4 times more common in males compared to females 2,3 and there is an approximately twofold higher risk among Caucasian compared to African American men. 2 Cigarette smoking, 4,5 occupational exposures to aromatic amines 6-8 and schistosomal infections 9,10 have been associated with risk of bladder cancer. Other environmental factors, including selenium intake, 8 chlorination by-products 11,12 and low dose arsenic levels in water sources, 13,14 have also been associated with bladder cancer, but are less well-established.Epidemiologic evidence suggests that use of nonsteroidal antiinflammatory drugs (NSAIDs), particularly aspirin, may lower the risk of several cancers, 15-20 including bladder cancer. 21 Several epidemiologic studies on urinary tract infections, 22,23 indwelling catheters, 24 bladder stones 25 and schistosomiasis 26 all support a role for inflammation in bladder carcinogenesis. In addition, recent animal and cell line studies show that risk of bladder cancer may be associated with inflammation and upregulation of cycloxygenase-2 (COX-2). 27...

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Comparison of genomic damage caused by 5-nitrofurantoin in young and adult mice using the in vivo micronucleus assay

Fučić

Marković

Ferenčić

et al. 2005

Environ. Mol. Mutagen.

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The antibiotic 5-nitrofurantoin (5-NF) has been used widely for the treatment of urosepsis in children during the last 20 years. Recent experimentation suggests the need for reevaluating its genotoxic potential. Because of possible differences in the metabolism and clearance of 5-NF in young and adult animals, we conducted a study to determine whether micronuclei caused by 5-NF were age-related. The in vivo micronucleus (MN) assay was performed on 3- and 8-week-old mice given single intraperitoneal injections of 5, 10, and 50 mg/kg 5-NF. Blood samples from the tail vein were taken before injection (baseline) and at 48, 96, 168, and 336 hr (2 weeks) after the treatment. One thousand reticulocytes were analyzed for micronuclei from each animal. Compared to similar baseline values for young and adult mice, 5-NF caused a significant increase in MN frequency in both age groups. The mean MN frequency in the young animals was higher than in the adult animals for each dose and sampling time. MN frequencies remained significantly elevated in young animals even 2 weeks after exposure to 5-NF. The results of the study confirm the genotoxic potential of 5-NF in young and adult animals, and indicate that young animals are more sensitive to the genotoxic effects of 5-NF than adult mice and that the response in young mice persists for a significantly longer time. These findings may be related to poorly developed mechanisms of xenobiotic detoxification and renal elimination in young animals.

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Acetaminophen, Some other Drugs, Some Diseases and the Risk of Transitional Cell Carcinoma: A population-based case-control study

Cited by 38 publications

References 25 publications

Cancer risk in persons receiving prescriptions for paracetamol: A Danish cohort study

Cancer risk in persons receiving prescriptions for paracetamol: A Danish cohort study

Nonsteroidal antiinflammatory drug use and risk of bladder cancer in the health professionals follow‐up study

Comparison of genomic damage caused by 5-nitrofurantoin in young and adult mice using the in vivo micronucleus assay

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