《癌症忠诚卡研究（CLOCS）中：观察性病例对照研究》购买非处方药物与卵巢癌诊断之间的关联。
Association Between Purchase of Over-the-Counter Medications and Ovarian Cancer Diagnosis in the Cancer Loyalty Card Study (CLOCS): Observational Case-Control Study.
机构信息
Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom.
Department of Behavioural Science and Health, University College London, London, United Kingdom.
出版信息
JMIR Public Health Surveill. 2023 Jan 26;9:e41762. doi: 10.2196/41762.
BACKGROUND
Over-the-counter (OTC) medications are frequently used to self-care for nonspecific ovarian cancer symptoms prior to diagnosis. Monitoring such purchases may provide an opportunity for earlier diagnosis.
OBJECTIVE
The aim of the Cancer Loyalty Card Study (CLOCS) was to investigate purchases of OTC pain and indigestion medications prior to ovarian cancer diagnosis in women with and without ovarian cancer in the United Kingdom using loyalty card data.
METHODS
An observational case-control study was performed comparing purchases of OTC pain and indigestion medications prior to diagnosis in women with (n=153) and without (n=120) ovarian cancer using loyalty card data from two UK-based high street retailers. Monthly purchases of pain and indigestion medications for cases and controls were compared using the Fisher exact test, conditional logistic regression, and receiver operating characteristic (ROC) curve analysis.
RESULTS
Pain and indigestion medication purchases were increased among cases 8 months before diagnosis, with maximum discrimination between cases and controls 8 months before diagnosis (Fisher exact odds ratio [OR] 2.9, 95% CI 2.1-4.1). An increase in indigestion medication purchases was detected up to 9 months before diagnosis (adjusted conditional logistic regression OR 1.38, 95% CI 1.04-1.83). The ROC analysis for indigestion medication purchases showed a maximum area under the curve (AUC) at 13 months before diagnosis (AUC=0.65, 95% CI 0.57-0.73), which further improved when stratified to late-stage ovarian cancer (AUC=0.68, 95% CI 0.59-0.78).
CONCLUSIONS
There is a difference in purchases of pain and indigestion medications among women with and without ovarian cancer up to 8 months before diagnosis. Facilitating earlier presentation among those who self-care for symptoms using this novel data source could improve ovarian cancer patients' options for treatment and improve survival.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03994653; https://clinicaltrials.gov/ct2/show/NCT03994653.
背景
在诊断前，非处方（OTC）药物常被用于自我治疗非特异性卵巢癌症状。监测这些购买行为可能为早期诊断提供机会。
目的
利用会员卡数据，通过观察性病例对照研究，调查英国卵巢癌患者和非卵巢癌患者在诊断前购买 OTC 止痛和消化不良药物的情况。
方法
采用病例对照研究，通过英国两家大型零售商的会员卡数据，比较诊断前卵巢癌患者（n=153）和非卵巢癌患者（n=120）购买 OTC 止痛和消化不良药物的情况。采用 Fisher 精确检验、条件逻辑回归和受试者工作特征（ROC）曲线分析比较病例和对照每月购买止痛和消化不良药物的情况。
结果
卵巢癌患者在诊断前 8 个月出现疼痛和消化不良药物购买量增加，在诊断前 8 个月时病例与对照组之间的区分度最大（Fisher 确切比值比[OR]2.9，95%置信区间[CI]2.1-4.1）。在诊断前 9 个月时，发现消化不良药物购买量增加（调整后的条件逻辑回归 OR 1.38，95%CI 1.04-1.83）。ROC 分析显示，消化不良药物购买量的最大曲线下面积（AUC）出现在诊断前 13 个月（AUC=0.65，95%CI 0.57-0.73），当分层至晚期卵巢癌时，AUC 进一步提高（AUC=0.68，95%CI 0.59-0.78）。
结论
在诊断前 8 个月，卵巢癌患者和非卵巢癌患者购买疼痛和消化不良药物存在差异。利用这一新颖的数据来源，促进那些自我治疗症状的患者更早就诊，可能会改善卵巢癌患者的治疗选择并提高生存率。
试验注册
ClinicalTrials.gov NCT03994653；https://clinicaltrials.gov/ct2/show/NCT03994653。
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