@Article{info:doi/10.2196/50402,
author="Cheng, Vienna
and Sayre, Eric C
and Cheng, Vicki
and Garg, Ria
and Gill, Sharlene
and Farooq, Ameer
and De Vera, Mary A",
title="Patterns of Prescription Medication Use Before Diagnosis of Early Age-Onset Colorectal Cancer: Population-Based Descriptive Study",
journal="JMIR Cancer",
year="2024",
month="Jul",
day="12",
volume="10",
pages="e50402",
keywords="colorectal cancer; medications; medication patterns; cancer diagnosis; prediagnosis; prescriptions; patterns; early-onset; population-based; incidence; male individuals; female individuals; health databases; pharmacology; diagnostic; descriptive study; gastroenterology; cancers",
abstract="Background: Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively. Objective: The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis. Methods: We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as ``cases''), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older). Results: We included 1001 EAO-CRC cases (n=450, 45{\%} female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7{\%}) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1{\%}). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1{\%}) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95{\%} CI 1.2-1.7) and with more frequent fills (OR 1.8, 95{\%} CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95{\%} CI 5.8-9.4) and with more frequent fills (OR 15.6, 95{\%} CI 13.1-18.6). Conclusions: We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC. ",
issn="2369-1999",
doi="10.2196/50402",
url="https://cancer.jmir.org/2024/1/e50402",
url="https://doi.org/10.2196/50402"
}