Nonhormonal drugs and cancer.

Abstract

Nonhormonal drugs probably account for only a small proportion of human cancer but have contributed many valuable insights into carcinogenic mechanisms. The antineoplastics, radiopharmaceuticals, and a few other agents account for most of the known drug-induced cancer. A number of other agents are under suspicion, usually due to studies in laboratory animals or to preliminary clinical or epidemiologic observations. This group includes some drugs in widespread use such as clofibrate and cimetidine. For a few drugs that are carcinogenic in animals, such as dapsone and isoniazid, epidemiologic studies have shown little to no evidence of carcinogenicity. Recent experimental studies have shown tumor promotion by the commonly used antidepressants amitriptyline and fluoxetine and some antihistamines, which deserve epidemiologic investigation of cancer risk. Some drugs may also protect against cancer, as suggested by the lower risk of colorectal cancer among regular users of nonsteroidal antiinflammatory drugs. Pharmacoepidemiologic studies must take into account possible confounding by the original conditions for which drugs were taken and the typically long latency period of drug-induced cancer. Improved postmarketing surveillance, continued routine case-control surveillance, and ad hoc case-control and cohort studies are needed to evaluate drugs already in use as well as newly introduced agents. -Environ Health Perspect 103 (Suppl 8):191-196 (1995)

Association between Low blood lead levels and increased risk of dental caries in children: a cross-sectional study

“…Nutritional status of calcium and iron can influence an individual’s susceptibility to lead toxicity [26]. However, blood lead levels were not associated with calcium and iron concentrations in the subjects of the present study.…”

A Critical Review of the Effectiveness of Rodent Pharmaceutical Carcinogenesis Testing in Predicting for Human Risk

“…Identifying carcinogenic drugs is difficult because of the typically long latent period of cancer, the inability to distinguish drug-induced cancers from those induced by other agents and conditions, and the general lack of epidemiologic surveillance for drug-induced cancer. 38 However, a major clinical epidemiologic study from 1969 to 1973 reviewed 215 drugs, of which 31 had a positive association with cancer risk and 41 had a negative correlation, or potentially a protective effect. These results may have discouraged significant further epidemiologic research funding on pharmaceutical carcinogenesis.…”

Estimating avoidable causes of cancer.

“…In addition to hormones, many of the drugs used in cancer chemotherapy have been linked with increasing the risk of second primary tumors (35). The carcinogenic activity of the antineoplastic drugs mandates long-term monitoring of the fate of cancer patients, which necessitates quality cancer registries.…”