| Summary: | 博士 === 國立陽明大學 === 生物醫學資訊研究所 === 105 === Background: Cancer already becomes one kind of chronic diseases and cancer treatment accounted for 13% of total health insurance in Taiwan. Chemoprevention is one kind of cancer prevention which usually obtained by using pharmacologic or natural agents that could arrest or reverse carcinogenesis process. It has grown up over the past two decades and some drugs have been approved as chemoprevention by U.S. Food and Drug Administration such as tamoxifen or raloxifene to prevent breast cancer. In recent years, several epidemiologic studies showed that the long-term-use drugs for chronic diseases such as aspirin, statin, metformin etc. were significantly associated with decreased specific cancer risk. Although the cancer prevention could not be considered as a primary intention for prescribing long-term-use drugs as it is indicated for other chronic diseases. But if we could understand the effect of long-term-use drugs for changing cancer risk, we could adjust the current type or dose of the drug or select drug which could have cancer prevention to reduce individual overall cancer risk. For example, if anyone needed to take long-term-use drugs for chronic disease and they might also have high cancer risk, the clinician could also consider the associations between long-term-use drugs and cancer risk. Till date, the associations between long-term-use drugs and cancer are not well established. The explorations should be extended to each combination of each drug, each cancer, gender and age group.
Aim: The aim of this study is to use systems approach for exploring cancer risk with long-term-use drugs.
Materials and Methods: In this study, we used two million cohort sample population (1999 - 2013 year) from National Health Insurance Research Database (NHIRD). We established a temporal model (case-control design) to explore comprehensive associations between the risk of top 20 cancer incidence and long-term-use drugs for chronic disease, including antihypertensive, antihyperlipidemic, antidiabetic, antihyperuricemic, anxiolytic, hypnotic, sedative and nonsteroidal anti-inflammatory drugs.
Results: The results from this study are associations, not causations. There were 79,245 cancer cases and 316,980 matched controls that are included in this study. After using a systems approach for cancer risk with long-term-use drugs, total were 47,080 associations and 2,516 associations were significate. A web-based system which includes comprehensive associations contain 3 domains: (1) Cancer incidence, (2) Drug and Cancer, (3) Overview (Please visit at http://cancerpp.phr.tmu.edu.tw/). The associations between long-term-use drugs and cancer disease are shown in adjusted odds ratio (AOR) with 95% Confidence Interval (CI) by adjusting the other confounders.
Conclusions: Systems approach for exploring cancer risk with long-term-use drugs by temporal model. Visualization of the associations could help to enlist the long-term-use drugs with personalized cancer risk and researchers directly would able to quantify them. It could help develop research on chemoprevention, for example, conducting randomized control trials. Individuals with chronic diseases and family history of cancer or high risk of specific cancer can also be prescribed with the more suitable drug. It would play an important role in personalized cancer prevention.
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