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Proguanil and atovaquone use is associated with lower colorectal cancer risk: a nationwide cohort study

Zhang, Naiqi ; Sundquist, Jan ; Sundquist, Kristina ; Ji, Jianguang

BMC medicine, 2022-11, Vol.20 (1), p.1-439, Article 439 [Periódico revisado por pares]

London: BioMed Central Ltd

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Título:
Proguanil and atovaquone use is associated with lower colorectal cancer risk: a nationwide cohort study
Autor: Zhang, Naiqi ; Sundquist, Jan ; Sundquist, Kristina ; Ji, Jianguang
Assuntos: Atovaquone ; Cancer ; Cancer and Oncology ; Cancer och onkologi ; Chemoprevention ; Chronic obstructive pulmonary disease ; Clinical Medicine ; Cohort analysis ; Colonoscopy ; Colorectal cancer ; Colorectal carcinoma ; Comorbidity ; Confidence intervals ; Country of birth ; Disease prevention ; Drug dosages ; Family history ; Family medical history ; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ; Genetics ; Health risks ; Health Sciences ; Hälsovetenskap ; Inflammatory bowel disease ; Klinisk medicin ; Malaria ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Population studies ; Prescriptions ; Prevention ; Proguanil ; Public Health, Global Health, Social Medicine and Epidemiology ; Risk factors ; Risk management ; Risk reduction ; Statistical analysis ; Statistics ; Vector-borne diseases
É parte de: BMC medicine, 2022-11, Vol.20 (1), p.1-439, Article 439
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Background Individuals with a family history of colorectal cancer (CRC) are at a high risk of developing CRC. Preclinical studies suggest that the anti-malaria drug proguanil and atovaquone might play a role in preventing CRC, but population-based evidence is still lacking. Methods By accessing a couple of nationwide Swedish registers, we performed a cohort study to explore whether using proguanil and atovaquone might associate with a lower risk of CRC by adopting a new-user study design. Adults who have 1 or more first-degree relatives (parents or siblings) diagnosed with CRC were identified and linked with the Prescribed Drug Register to evaluate their administration history of proguanil and atovaquone. Survival analysis of the time to CRC diagnosis with Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results A total of 16,817 incident proguanil/atovaquone users were identified and matched with 168,170 comparisons, who did not use proguanil/atovaquone, on the ratio of 1:10. We found a significant negative association between proguanil/atovaquone use and risk of CRC (adjusted HR, 0.76; 95% CI, 0.62-0.93). Test for trend showed significant dose- and duration-response correlations (P < 0.001). The association was more pronounced in CRC diagnosed at an advanced stage than at an early stage (adjusted HR, 0.69 vs.0.81). Conclusions This national-wide population-based cohort study showed that the use of proguanil and atovaquone was associated with a reduced risk of CRC among individuals with a family history of CRC. Keywords: Proguanil, Atovaquone, Colorectal cancer, Family history, Chemoprevention
Editor: London: BioMed Central Ltd
Idioma: Inglês

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Proguanil and atovaquone use is associated with lower colorectal cancer risk: a nationwide cohort study

Zhang, Naiqi ; Sundquist, Jan ; Sundquist, Kristina ; Ji, Jianguang

London: BioMed Central Ltd

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