TY  - JOUR
AU  - Cheng, Vienna
AU  - Sayre, Eric C
AU  - Cheng, Vicki
AU  - Garg, Ria
AU  - Gill, Sharlene
AU  - Farooq, Ameer
AU  - De Vera, Mary A
PY  - 2024
DA  - 2024/7/12
TI  - Patterns of Prescription Medication Use Before Diagnosis of Early Age-Onset Colorectal Cancer: Population-Based Descriptive Study
JO  - JMIR Cancer
SP  - e50402
VL  - 10
KW  - colorectal cancer
KW  - medications
KW  - medication patterns
KW  - cancer diagnosis
KW  - prediagnosis
KW  - prescriptions
KW  - patterns
KW  - early-onset
KW  - population-based
KW  - incidence
KW  - male individuals
KW  - female individuals
KW  - health databases
KW  - pharmacology
KW  - diagnostic
KW  - descriptive study
KW  - gastroenterology
KW  - cancers
AB  - 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. 
SN  - 2369-1999
UR  - https://cancer.jmir.org/2024/1/e50402
UR  - https://doi.org/10.2196/50402
DO  - 10.2196/50402
ID  - info:doi/10.2196/50402
ER  -