Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1072, New Zealand.
Te Aho o Te Kahu, Cancer Control Agency, Wellington 6011, New Zealand.
Int J Environ Res Public Health. 2020 Oct 29;17(21):7962. doi: 10.3390/ijerph17217962.
Assessing the use of multiple medications in cancer patients is crucial as such use may affect cancer outcomes. This study reports the prevalence of non-cancer medication use at breast cancer diagnosis, its associated factors, and its effect on survival.
We identified all women diagnosed with primary invasive breast cancer between 1 January 2007 and 31 December 2016, from four population-based breast cancer registries, in Auckland, Waikato, Wellington, and Christchurch, New Zealand. Through linkage to the pharmaceutical records, we obtained information on non-cancer medications that were dispensed for a minimum of 90 days' supply between one year before cancer diagnosis and first cancer treatment. We performed ordered logistic regressions to identify associated factors and Cox regressions to investigate its effect on patient survival.
Of 14,485 patients, 52% were dispensed at least one drug (mean-1.3 drugs; maximum-13 drugs), with a higher prevalence observed in patients who were older, treated at a public facility, more economically deprived, and screen-detected. The use of 2-3 drugs showed a reduced non-breast cancer mortality (HR = 0.75, 95%CI = 0.60-0.92) in previously hospitalised patients, with other groups showing non-significant associations when adjusted for confounding factors. Drug use was not associated with changes in breast cancer-specific mortality.
Non-cancer medication use at breast cancer diagnosis was common in New Zealand, more prevalent in older and disadvantaged women, and showed no effect on breast cancer-specific mortality, but a reduction in other cause mortality with the use of 2-3 drugs.
评估癌症患者使用多种药物的情况至关重要,因为这种使用可能会影响癌症的结果。本研究报告了乳腺癌诊断时非癌症药物使用的流行率、其相关因素及其对生存的影响。
我们从新西兰奥克兰、怀卡托、惠灵顿和克赖斯特彻奇的四个基于人群的乳腺癌登记处,确定了 2007 年 1 月 1 日至 2016 年 12 月 31 日期间所有被诊断为原发性浸润性乳腺癌的女性。通过与药品记录的链接,我们获得了在癌症诊断前一年至首次癌症治疗期间至少 90 天供应量的非癌症药物的信息。我们进行有序逻辑回归以确定相关因素,并进行 Cox 回归以调查其对患者生存的影响。
在 14485 名患者中,52%的患者至少开了一种药物(平均 1.3 种药物;最大 13 种药物),在年龄较大、在公共设施接受治疗、经济状况较差和筛查发现的患者中,这种情况更为常见。在以前住院的患者中,使用 2-3 种药物可降低非乳腺癌死亡率(HR = 0.75,95%CI = 0.60-0.92),而其他组在调整混杂因素后则无显著相关性。药物使用与乳腺癌特异性死亡率的变化无关。
在新西兰,乳腺癌诊断时非癌症药物的使用很常见,在年龄较大和处于不利地位的女性中更为普遍,并且对乳腺癌特异性死亡率没有影响,但使用 2-3 种药物可降低其他原因导致的死亡率。