Use of acetaminophen in relation to the occurrence of cancer: a review of epidemiologic studies

Abstract

Acetaminophen has several pharmacologic properties that suggest it could be carcinogenic in human beings. A number of epidemiologic studies have been conducted to examine whether use of acetaminophen actually predisposes to the occurrence of one or more forms of cancer. There are inherent limitations to many of these studies, including the inaccurate identification of users and nonusers of acetaminophen, relatively short follow-up for cancer incidence, and the potential for confounding by indication. The present manuscript reviews the results of epidemiologic studies of acetaminophen use in relation to cancer incidence published through the end of 2015. The limitations of the underlying studies notwithstanding, some interim conclusions can be reached. For all but several forms of cancer, there is no suggestion that persons who have taken acetaminophen are at altered risk, even persons who have consumed a large quantity of the drug or those who have taken it for an extended duration. While in some studies the incidence of renal cell carcinoma has been observed to be increased among acetaminophen users, several other studies have failed to observe any such association; the reason for the discrepant findings is unclear. Some of the small number of studies that have presented data on the incidence of lymphoma, leukemia, and plasma cell disorders have found the risk to be modestly higher in users than nonusers of acetaminophen, but the results of other studies of these malignancies will be needed to gauge the possible role of publication bias as the basis for the positive results.

Paracetamol Intake and Hematologic Malignancies: A Meta-Analysis of Observational Studies

“…This means that some relevant studies may not have been published and, therefore, were not included in the meta-analysis, which could potentially affect the results. This issue has been mentioned by previous narrative reviews [ 12 ]. In our meta-analysis, we did not include any limitation on language, year, or type of study.…”

“…We contacted the authors if additional information on a report was needed. Furthermore, reference lists of original reports and narrative reviews were examined to identify additional relevant citations [ 12 ]. No limitation on language was set.…”

“…However, while some studies showed increased risk, others failed to do so [ 11 ]. Moreover, publication bias could have possibly distorted the global association between paracetamol and hematologic cancer [ 12 ]. Because of the considerable consumption of paracetamol worldwide, any association with increased or decreased risk of cancer may have important public health implications.…”

Anesthesia and cancer recurrence: an overview

“…Paracetamol can be administered in combination with opioids or NSAIDs to increases the analgesic efficacy and reduce daily morphine consumption [137]. Analyzing the current literature, the relationship between paracetamol usage and cancer recurrence are conflicting: increased risks for urinary tract cancers and decreased risk for ovarian cancer [138,139]. However, the results reached so far have been inconsistent.…”