Contrasting Improving Rates of Cancer Survival In The Context of Life Years Lost Compared To The General Population

Abstract

controls based on gender, birth year and year of start enrolment in the PHARMO Database Network. Matched controls received the same index date as their matched case. Cases and controls were not allowed to have a diagnosis of cancer before index date. The association between the use of antipsychotics (either typical, atypical or lithium) before index date and risk of CRC was estimated using conditional logistic regression. Results: A total of 29,490 CRC cases and 117,960 controls were identified. The use of any antipsychotic before index date was slightly higher among controls compared to CRC cases [3% vs. 2%] resulted in an odds ratio (OR) of 0.64 (95% CI 0.59-0.70) for CRC. Stratification by typical or atypical antipsychotics yielded almost the same OR. A different OR was seen for lithium: 1.17 (95% CI: 0.94-1.45) and increased with long term use [≥ 5 years: 1.60 (95% CI: 1.12-2.31). Also, the OR of lithium differed between tumour sites: [proximal colon: 1.09 (95% CI: 0.78-1.53); distal colon: 1.44 (95% CI: 1.00-2.08) and rectum: 1.04 (95% CI: 0.65-1.65)], which was not seen for atypical or typical antipsychotics. ConClusions: Overall, no association was seen between the use of antipsychotics and the risk of CRC. However, an increased risk of CRC was seen with long term lithium use and differed between specific tumour sites.