Considerations for Pharmacoepidemiological Studies of Drug –Cancer Associations

We present methods to examine early and late effects of drug use on cancer development and discuss the need for employing ‘lag‐time’ in order to avoid reverse causation. We emphasize that a new‐user study design should always be considered. We also underline the need for ‘dose–response’ analyses, as drug–cancer associations are likely to be dose‐dependent. Generally, studies of drug–cancer associations should explore risk of site‐specific cancer, rather than cancer overall. Additional differentiation may also be crucial for organ‐specific cancer with various distinct histological subtypes (e.g., lung or ovary cancer). We also highlight the influence of confounding factors and discuss various methods to address confounding, while emphasizing that the choices of methods depend on the design and specific objectives of the individual study. In some studies, use of active comparator(s) may be preferable. Pharmacoepidemiological studies of drug–cancer associations are expected to evolve considerably in the coming years, due to the increasing availability of long‐term data on drug exposures and cancer outcomes, the increasing conduct of multinational studies, allowing studies of rare cancers and subtypes of cancer, and methodological improvements specifically addressing cancer and other long‐term outcomes.
Source: Basic and Clinical Pharmacology and Toxicology - Category: Drugs & Pharmacology Authors: Tags: MiniReview Source Type: research