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Exposure to antimuscarinic medications for treatment of overactive bladder and risk of lung cancer and colon cancer

Authors Löfling L, Sundström A, Kieler H, Bahmanyar S, Linder M

Received 7 September 2018

Accepted for publication 12 December 2018

Published 23 January 2019 Volume 2019:11 Pages 133—143

DOI https://doi.org/10.2147/CLEP.S186842

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Professor Vera Ehrenstein


Lukas Löfling, Anders Sundström, Helle Kieler, Shahram Bahmanyar, Marie Linder

Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institute, Solna, Sweden

Introduction: One out of six adults has symptoms of overactive bladder (OAB). Antimuscarinic medication is the main pharmacological group used in the treatment of OAB. In preclinical studies, antimuscarinic compounds have been found to inhibit cell proliferation in lung cancer and colon cancer.
Objective: The aim of this study was to investigate the association between exposure to antimuscarinic medication and the risk of lung cancer and colon cancer.
Methods: Individuals in Sweden who first filled a prescription for an antimuscarinic medication used to treat OAB (ie, oxybutynin, solifenacin, darifenacin, fesoterodine, or tolterodine) between July 1, 2006, and December 31, 2012, were identified and classified as exposed. Each exposed individual was individually matched with up to ten unexposed individuals from the Swedish general population, based on year of birth, sex, and county of residence. Cox proportional hazard models with follow-up time as the underlying time scale were used to estimate HRs with 95% CIs.
Results: In total, 164,000 exposed and 1,446,472 unexposed individuals were included in this study. The estimated HRs for lung cancer, in follow-up time intervals of <1 year, 1–4 years, and ≥4 years, were as follows: 0.86 (95% CI: 0.75–0.98), 0.63 (95% CI: 0.56–0.70), and 0.43 (0.34–0.55), respectively. The corresponding estimates for colon cancer were as follows: 0.91 (95% CI: 0.80–1.03), 0.81 (95% CI: 0.74–0.88), and 0.61 (95% CI: 0.51–0.73), respectively.
Conclusion: There was an inverse association between exposure to antimuscarinic medications, used in the treatment of OAB, and a diagnosis of colon cancer or lung cancer, which is in line with the findings in preclinical studies.

Keywords: overactive bladder, antimuscarinic medications, lung cancer, colon cancer
 

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