Dataset Information

External adjustment of unmeasured confounders in a case-control study of benzodiazepine use and cancer risk.

ABSTRACT:

Aims

Previous studies have reported diverging results on the association between benzodiazepine use and cancer risk.

Methods

We investigated this association in a matched case-control study including incident cancer cases during 2002-2009 in the Danish Cancer Registry (n = 94?923) and age- and sex-matched (1:8) population controls (n = 759?334). Long-term benzodiazepine use was defined as ?500 defined daily doses 1-5 years prior to the index date. We implemented propensity score (PS) calibration using external information on confounders available from a survey of the Danish population. Two PSs were used: The error-prone PS using register-based confounders and the calibrated PS based on both register- and survey-based confounders, retrieved from the Health Interview Survey.

Results

Register-based data showed that cancer cases had more diagnoses, higher comorbidity score and more co-medication then population controls. Survey-based data showed lower self-rated health, more self-reported diseases, and more smokers as well as subjects with sedentary lifestyle among benzodiazepine users. By PS calibration, the odds ratio for cancer overall associated with benzodiazepine use decreased from 1.16 to 1.09 (95% confidence interval 1.00-1.19) and for smoking-related cancers from 1.20 to 1.10 (95% confidence interval 1.00-1.21).

Conclusion

We conclude that the increased risk observed in the solely register-based study could partly be attributed to unmeasured confounding.

SUBMITTER: Thygesen LC

PROVIDER: S-EPMC5651330 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

External adjustment of unmeasured confounders in a case-control study of benzodiazepine use and cancer risk.

Thygesen Lau Caspar LC Pottegård Anton A Ersbøll Annette Kjaer AK Friis Søren S Stürmer Til T Hallas Jesper J

British journal of clinical pharmacology 20170712 11

<h4>Aims</h4>Previous studies have reported diverging results on the association between benzodiazepine use and cancer risk.<h4>Methods</h4>We investigated this association in a matched case-control study including incident cancer cases during 2002-2009 in the Danish Cancer Registry (n = 94 923) and age- and sex-matched (1:8) population controls (n = 759 334). Long-term benzodiazepine use was defined as ≥500 defined daily doses 1-5 years prior to the index date. We implemented propensity score ( ...[more]

PMID: 28599067

Similar Datasets

Project description:BackgroundConcerns were raised about pneumonia development from benzodiazepines (BZDs) and Z-drugs, but direct evidence is limited, conflicting and without examining the highly susceptible patients with chronic kidney disease (CKD) nor specifying the risk for different drug utilizations. This study aimed to investigate whether use of BZDs and Z-drugs was each associated with an increased risk of pneumonia in a CKD population.MethodsWe performed a nested case-control study of 36,880 CKD patients analyzing the Taiwan National Health Insurance Database between 01/1/2000 and 12/31/2011. Among the study cohort, we identified 4,533 cases of pneumonia based on validated disease codes, chest x-ray examination, and prescriptions of respiratory antibiotics, and randomly selected 16,388 controls from risk sets, matched by sex, age, and number of CKD-related hospitalizations. All prescription filling records of BZDs and Z-drugs in the year before the event/index date were analyzed for cases and controls. Conditional logistic regressions were performed to estimate the odds ratios (ORs).ResultsCurrent use of BZDs was associated with a 1.31-fold (95% CI, 1.18-1.26) increased risk of pneumonia compared to nonuse, but not for recent and past use. The risk from current BZD use was confined to new initiation (adjusted OR, 2.47; 95% CI, 2.02-3.03) or use for ≤ 30 days, and elevated to 2.88-fold (95% CI, 1.87-4.42) with parenteral administration. New initiation and current short-term use of Z-drugs was associated with a 2.94-fold (95% CI, 1.65-5.26) and 1.75-fold (95% CI, 1.13-2.72) increased risk of pneumonia, respectively. The findings were robust to adoption of a case-crossover study that analyzed cases only.ConclusionsUse of BZRAs is associated with an increased risk of pneumonia in CKD patients, especially for patients newly initiating BZDs or Z-drugs or those injected with BZDs. Physicians should exercise cautions for signs of pneumonia when prescribing BZDs or Z-drugs to CKD patients.

Dataset Information

External adjustment of unmeasured confounders in a case-control study of benzodiazepine use and cancer risk.

Aims

Methods

Results

Conclusion

Publications

External adjustment of unmeasured confounders in a case-control study of benzodiazepine use and cancer risk.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets