Patterns of Prescription Medication Use Before Diagnosis of Early Age-Onset Colorectal Cancer: Population-Based Descriptive Study.

IF 3.3 Q2 ONCOLOGY
JMIR Cancer Pub Date : 2024-07-12 DOI:10.2196/50402
Vienna Cheng, Eric C Sayre, Vicki Cheng, Ria Garg, Sharlene Gill, Ameer Farooq, Mary A De Vera
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引用次数: 0

Abstract

Background: Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively.

Objective: The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis.

Methods: We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as "cases"), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older).

Results: We included 1001 EAO-CRC cases (n=450, 45% female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7%) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1%). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1%) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95% CI 1.2-1.7) and with more frequent fills (OR 1.8, 95% CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95% CI 5.8-9.4) and with more frequent fills (OR 15.6, 95% CI 13.1-18.6).

Conclusions: We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC.

早发性大肠癌确诊前的处方药使用模式:基于人群的描述性研究
背景:据估计,结直肠癌(CRC)是加拿大第四大常见癌症(非黑色素瘤皮肤癌除外),也是男性和女性癌症相关死亡的第二和第三大原因:早发性结直肠癌(EAO-CRC;诊断年龄小于 50 岁)发病率的上升要求我们更好地了解患者的诊断途径。因此,我们对 EAO-CRC 诊断前的处方药使用模式进行了评估:我们使用加拿大不列颠哥伦比亚省(BC)的链接行政健康数据库,确定了 2010 年 1 月 1 日至 2016 年 12 月 31 日期间确诊为 EAO-CRC 的患者(以下简称 "病例"),以及按年龄和性别匹配的无癌症对照组(1:10)。我们确定了确诊前一年社区药房开具的所有处方,并使用解剖学治疗化学分类系统三级将处方按照药物类别分组。同时还对诊断为平均年龄发病的 CRC 患者(诊断年龄在 50 岁及以上)进行了评估:我们纳入了 1001 例 EAO-CRC 病例(n=450,女性参与者占 45%;平均 41.0 岁,SD 6.1 岁),其中 797 人(79.7%)在确诊前一年内服用了 12,989 种处方药。最常用的药物是抗抑郁药(第一位;n=1698,13.1%)。与对照组相比,EAO-CRC 病例更有可能服用治疗消化性溃疡病和胃食管反流病的药物(第三位,人数=795,占 6.1%)(几率比 [OR] 1.4,95% CI 1.2-1.7),而且服用频率更高(OR 1.8,95% CI 1.7-1.9)。我们注意到治疗痔疮和肛裂的外用药也有类似的情况,与对照组相比,EAO-CRC 病例更有可能使用外用药(OR 7.4,95% CI 5.8-9.4),而且使用频率更高(OR 15.6,95% CI 13.1-18.6):我们观察到,在确诊 EAO-CRC 之前的一年中,患者频繁使用处方药,包括治疗 EAO-CRC 常见症状的药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JMIR Cancer
JMIR Cancer ONCOLOGY-
CiteScore
4.10
自引率
0.00%
发文量
64
审稿时长
12 weeks
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