Dataset Information

Tetracycline use and risk of incident skin cancer: a prospective study.

ABSTRACT:

Background

Tetracycline is a photosensitising medication that increases skin vulnerability to UV-related damage.

Methods

We prospectively examined tetracycline use and risk of incident melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) based on 213?536 participants from the Nurses' Health Study (NHS), NHS2, and Health Professionals Follow-up Study. Information on ever use of tetracycline was asked via questionnaire. Diagnoses of melanoma and SCC were pathologically confirmed.

Results

Tetracycline use was associated with a modestly increased risk of BCC (n_case=36?377), with a pooled hazard ratio (HR) of 1.11 (95% confidence interval (CI)=1.02-1.21, P-trend=0.05 by duration of use). Tetracycline use was not significantly associated with melanoma (n_case=1831, HR=1.09, 95% CI=0.94-1.27) or SCC (n_case=3332, HR=1.04, 95% CI=0.91-1.18) risk overall. However, we observed positive interactions between tetracycline use and adulthood UV exposure on SCC risk (P-interaction=0.05).

Conclusion

Tetracycline use was associated with a modestly increased risk of BCC, but was not associated with melanoma or SCC.

SUBMITTER: Li WQ

PROVIDER: S-EPMC5785738 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Publications

Tetracycline use and risk of incident skin cancer: a prospective study.

Li Wen-Qing WQ Drucker Aaron M AM Cho Eunyoung E Laden Francine F VoPham Trang T Li Suyun S Weinstock Martin A MA Qureshi Abrar A AA

British journal of cancer 20171026 2

<h4>Background</h4>Tetracycline is a photosensitising medication that increases skin vulnerability to UV-related damage.<h4>Methods</h4>We prospectively examined tetracycline use and risk of incident melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) based on 213 536 participants from the Nurses' Health Study (NHS), NHS2, and Health Professionals Follow-up Study. Information on ever use of tetracycline was asked via questionnaire. Diagnoses of melanoma and SCC were pathologi ...[more]

PMID: 29073637

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Project description:IMPORTANCE:Many medications have anticholinergic effects. In general, anticholinergic-induced cognitive impairment is considered reversible on discontinuation of anticholinergic therapy. However, a few studies suggest that anticholinergics may be associated with an increased risk for dementia. OBJECTIVE:To examine whether cumulative anticholinergic use is associated with a higher risk for incident dementia. DESIGN, SETTING, AND PARTICIPANTS:Prospective population-based cohort study using data from the Adult Changes in Thought study in Group Health, an integrated health care delivery system in Seattle, Washington. We included 3434 participants 65 years or older with no dementia at study entry. Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003. Beginning in 2004, continuous replacement for deaths occurred. All participants were followed up every 2 years. Data through September 30, 2012, were included in these analyses. EXPOSURES:Computerized pharmacy dispensing data were used to ascertain cumulative anticholinergic exposure, which was defined as the total standardized daily doses (TSDDs) dispensed in the past 10 years. The most recent 12 months of use was excluded to avoid use related to prodromal symptoms. Cumulative exposure was updated as participants were followed up over time. MAIN OUTCOMES AND MEASURES:Incident dementia and Alzheimer disease using standard diagnostic criteria. Statistical analysis used Cox proportional hazards regression models adjusted for demographic characteristics, health behaviors, and health status, including comorbidities. RESULTS:The most common anticholinergic classes used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. During a mean follow-up of 7.3 years, 797 participants (23.2%) developed dementia (637 of these [79.9%] developed Alzheimer disease). A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease (test for trend, P?<?.001). For dementia, adjusted hazard ratios for cumulative anticholinergic use compared with nonuse were 0.92 (95% CI, 0.74-1.16) for TSDDs of 1 to 90; 1.19 (95% CI, 0.94-1.51) for TSDDs of 91 to 365; 1.23 (95% CI, 0.94-1.62) for TSDDs of 366 to 1095; and 1.54 (95% CI, 1.21-1.96) for TSDDs greater than 1095. A similar pattern of results was noted for Alzheimer disease. Results were robust in secondary, sensitivity, and post hoc analyses. CONCLUSIONS AND RELEVANCE:Higher cumulative anticholinergic use is associated with an increased risk for dementia. Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time.

Dataset Information

Tetracycline use and risk of incident skin cancer: a prospective study.

Background

Methods

Results

Conclusion

Publications

Tetracycline use and risk of incident skin cancer: a prospective study.

Similar Datasets

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