ABSTRACT
PURPOSE: The incidence of renal cell carcinoma (RCC) is rising. Use of analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol may affect renal function. The aim of this study was to assess associations between analgesic use and risk of RCC. METHODS: A population-based case-control family design was used. Cases were recruited via two Australian state cancer registries. Controls were siblings or partners of cases. Analgesic use was captured by self-completed questionnaire. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for RCC risk associated with regular analgesic use (at least 5 times per month for 6 months or more) and duration and frequency of use. RESULTS: The analysis included 1064 cases and 724 controls. Regular use of paracetamol was associated with an increased risk of RCC (OR 1.41, 95%CI 1.13-1.77). Regular use of NSAIDs was associated with increased risk of RCC for women (OR 1.71, 95% CI 1.23-2.39) but not men (OR 0.83, 95% CI 0.58-1.18; p-interaction=0.003). There was no evidence of a dose-response for duration of use of paracetamol (linear trend p = 0.77) and weak evidence for non- aspirin NSAID use by women (linear trend p = 0.054). CONCLUSION: This study found that regular use of paracetamol was associated with increased risk of RCC. NSAID use was associated with increased risk only for women.
Subject(s)
Carcinoma, Renal Cell , Kidney Neoplasms , Acetaminophen/adverse effects , Analgesics/adverse effects , Australia/epidemiology , Carcinoma, Renal Cell/chemically induced , Carcinoma, Renal Cell/epidemiology , Female , Humans , Kidney Neoplasms/chemically induced , Kidney Neoplasms/epidemiologySubject(s)
Diet , Life Style , Neoplasms/epidemiology , Noncommunicable Diseases/epidemiology , Transients and Migrants , White People , Adult , Aged , Australia/epidemiology , Cohort Studies , Female , Humans , Male , Middle Aged , Prospective Studies , Risk FactorsABSTRACT
BACKGROUND: Studies investigating the association between treatment for precancerous changes in the cervix and risk of preterm birth have used a variety of comparison groups. OBJECTIVES: To investigate whether treatment for precancerous changes in the cervix is associated with preterm birth (<37 weeks) and to examine the impact of the type of comparison group on estimates of risk. SEARCH STRATEGY: PubMed, Embase and CENTRAL were searched for studies pubished between 1950 and 2009. SELECTION CRITERIA: Eligible studies were those that reported preterm birth outcomes for excisional and ablative treatments separately and included a comparison group. DATA COLLECTION AND ANALYSIS: Pooled relative risks (RR) and 95% confidence intervals were computed using a random effects model. MAIN RESULTS: Thirty eligible studies were located. Excisional treatment was associated with an increased odds of preterm birth, when compared with an external (RR 2.19, 95% CI 1.93-2.49) or internal (RR 1.96, 95% CI 1.46-2.64) comparison group. In comparison with women who were assessed but not treated, the risk estimate was smaller (RR 1.25, 95% CI 0.98-1.58). Ablative treatment was associated with an increased risk of preterm birth when an external comparison group (RR 1.47, 95% CI 1.24-1.74) but not an internal comparison group (RR 1.24, 95% CI 0.73-2.10) or untreated comparison group (RR 1.03, 95% CI 0.90-1.18) was used. AUTHORS' CONCLUSIONS: Excisional treatment was associated with a significantly increased risk of preterm birth. It provides new evidence that some types of ablative treatment may also be associated with a small increased risk. The type of comparison group used is an important consideration when comparing the outcomes of studies.
