Grant Number:	2R01CA098838-06 Interpret this number
Primary Investigator:	Habel, Laurel
Organization:	Kaiser Foundation Research Institute
Project Title:	Pharmaceuticals and Cancer
Fiscal Year:	2009

DESCRIPTION (provided by applicant): A growing proportion of children and adults take medication regularly, yet relatively few drugs have undergone significant post-marketing surveillance for adverse effects, including elevated cancer rates. The main objective of our originally funded proposal was to identify commonly prescribed drugs that are associated with lower or higher rates of cancer and examine whether these associations deserved further study. The study was conducted within Kaiser Permanente of Northern California (KPNC), a prepaid, integrated health plan with over 3.2 million currently active members. We conducted surveillance analyses (i.e., hypothesis generating) of the 230 most commonly prescribed drugs (at least 30,000 recipients from 1994-2003) with a special focus on the 115 drugs not examined in our previous program of surveillance of drugs for carcinogenicity, as well as several more in-depth analyses of drug-cancer associations (i.e., hypothesis testing). In this Renewal application, we are requesting funding to continue our surveillance of commonly prescribed drugs for carcinogenicity, as well as to examine selected drug-cancer associations of potential importance. This Renewal application builds on a drug surveillance program conducted within KPNC since the late 1970s. Specifically, we propose to: 1) Continue surveillance of commonly used prescription drugs for possible carcinogenic effects (i.e., hypothesis generation) among KPNC members with computer-stored pharmacy records since 1994, and 2) Conduct studies of selected drug-cancer associations found in the above screening analyses or from reports of human or animal studies (i.e., hypothesis testing). During the calendar period of the Renewal over two million of our members will be prescribed one or more drugs and approximately 18,000 members will be diagnosed with cancer per year for a total of approximately 320,000 cancers diagnosed among members during the period of study (1994-2013). The KPNC membership and databases continue to provide a unique resource for cost-efficient surveillance of a large number of prescription drugs for possible carcinogenic effects and for more in-depth studies of specific drug-cancer associations. The membership is large, stable, ethnically diverse, and receives virtually all of its health care from the pre-paid, integrated medical care program. Hard copy and electronic medical records are available with information on prescribed medications, cancer diagnoses, laboratory tests, and outpatient visits and hospitalizations. PUBLIC HEALTH RELEVANCE: New drug development continues at a rapid pace and a growing proportion of children and adults in the US take one or more medications on a regular basis. Yet despite growing public and scientific concern about potential health risks, there has been relatively little surveillance of commonly prescribed drugs for adverse effects, including elevated cancer rates. The Kaiser Permanente of Northern California surveillance program has been designed to detect signals of potential cancer risk associated with commonly prescribed drugs and to conduct more in-depth investigations of specific medications. Our program provides a valuable mechanism to identify early signs of possible carcinogenic effects of the most commonly used medications or reassurance as to their safety in this regard.




Hydrochlorothiazide and risk of melanoma subtypes.
Authors: Habel L.A. , Achacoso N. , Fireman B. , Pedersen S.A. , Pottegård A. .
Source: Pharmacoepidemiology And Drug Safety, 2021-05-07 00:00:00.0; , .
EPub date: 2021-05-07 00:00:00.0.
PMID: 33960576
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Initiation and adherence to adjuvant endocrine therapy among urban, insured American Indian/Alaska Native breast cancer survivors.
Authors: Emerson M.A. , Achacoso N.S. , Benefield H.C. , Troester M.A. , Habel L.A. .
Source: Cancer, 2021-02-23 00:00:00.0; , .
EPub date: 2021-02-23 00:00:00.0.
PMID: 33620753
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Gabapentin and Cancer Risk: Updated Findings from Kaiser Permanente Northern California.
Authors: Friedman G.D. , Achacoso N. , Habel L.A. .
Source: The Permanente Journal, 2019; 23, .
PMID: 30939265
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Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma.
Authors: Su K.A. , Habel L.A. , Achacoso N.S. , Friedman G.D. , Asgari M.M. .
Source: The British Journal Of Dermatology, 2018 Nov; 179(5), p. 1088-1094.
EPub date: 2018-08-14 00:00:00.0.
PMID: 29723931
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Patterns of medication adherence in a multi-ethnic cohort of prevalent statin users diagnosed with breast, prostate, or colorectal cancer.
Authors: Banegas M.P. , Emerson M.A. , Adams A.S. , Achacoso N.S. , Chawla N. , Alexeeff S. , Habel L.A. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2018-10-18 00:00:00.0; , .
EPub date: 2018-10-18 00:00:00.0.
PMID: 30338462
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A Cohort Study of Metformin and Colorectal Cancer Risk among Patients with Diabetes Mellitus.
Authors: Bradley M.C. , Ferrara A. , Achacoso N. , Ehrlich S.F. , Quesenberry C.P. , Habel L.A. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2018 May; 27(5), p. 525-530.
PMID: 29716927
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Haloperidol and Prostate Cancer Prevention: More Epidemiologic Research Needed.
Authors: Friedman G.D. , Habel L.A. , Achacoso N. , Sanders C.M. , Oyer H.M. , Fireman B. , Van Den Eeden S.K. , Kim F.J. .
Source: The Permanente Journal, 2018; 24, .
EPub date: 2019-11-22 00:00:00.0.
PMID: 31852040
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Disparities in Prostate, Lung, Breast, and Colorectal Cancer Survival and Comorbidity Status among Urban American Indians and Alaskan Natives.
Authors: Emerson M.A. , Banegas M.P. , Chawla N. , Achacoso N. , Alexeeff S.E. , Adams A.S. , Habel L.A. .
Source: Cancer Research, 2017-12-01 00:00:00.0; 77(23), p. 6770-6776.
EPub date: 2017-11-29 00:00:00.0.
PMID: 29187399
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Statins and Reduced Risk of Liver Cancer: Evidence for Confounding.
Authors: Friedman G.D. , Achacoso N. , Fireman B. , Habel L.A. .
Source: Journal Of The National Cancer Institute, 2016 10; 108(10), .
EPub date: 2016-07-05 00:00:00.0.
PMID: 27381455
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Use Of Sildenafil Or Other Phosphodiesterase Inhibitors And Risk Of Melanoma
Authors: Pottegård A. , Schmidt S.A. , Olesen A.B. , Achacoso N. , Van Den Eeden S.K. , Hallas J. , Sørensen H.T. , Friis S. , Habel L.A. .
Source: British Journal Of Cancer, 2016-09-27 00:00:00.0; 115(7), p. 895-900.
PMID: 27529513
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Metformin Use And Lung Cancer Risk In Patients With Diabetes
Authors: Sakoda L.C. , Ferrara A. , Achacoso N.S. , Peng T. , Ehrlich S.F. , Quesenberry C.P. , Habel L.A. .
Source: Cancer Prevention Research (philadelphia, Pa.), 2015 Feb; 8(2), p. 174-9.
PMID: 25644512
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Antidepressants And Testicular Cancer
Authors: Friedman G.D. , Schwalbe J. , Achacoso N. , Meng M.V. , Kroenke C.H. , Habel L.A. .
Source: Cancer Causes & Control : Ccc, 2014 Feb; 25(2), p. 251-8.
PMID: 24276357
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Patterns and predictors of breast cancer chemotherapy use in Kaiser Permanente Northern California, 2004-2007.
Authors: Kurian A.W. , Lichtensztajn D.Y. , Keegan T.H. , Leung R.W. , Shema S.J. , Hershman D.L. , Kushi L.H. , Habel L.A. , Kolevska T. , Caan B.J. , et al. .
Source: Breast Cancer Research And Treatment, 2013 Jan; 137(1), p. 247-60.
PMID: 23139057
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Antihypertensive Drugs And Lip Cancer In Non-hispanic Whites
Authors: Friedman G.D. , Asgari M.M. , Warton E.M. , Chan J. , Habel L.A. .
Source: Archives Of Internal Medicine, 2012-09-10 00:00:00.0; 172(16), p. 1246-51.
PMID: 22869299
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Risk Of Cancer In Patients Exposed To Gabapentin In Two Electronic Medical Record Systems
Authors: Irizarry M.C. , Webb D.J. , Boudiaf N. , Logie J. , Habel L.A. , Udaltsova N. , Friedman G.D. .
Source: Pharmacoepidemiology And Drug Safety, 2012 Feb; 21(2), p. 214-25.
PMID: 22144034
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Racial/ethnic differences in initiation of adjuvant hormonal therapy among women with hormone receptor-positive breast cancer.
Authors: Livaudais J.C. , Hershman D.L. , Habel L. , Kushi L. , Gomez S.L. , Li C.I. , Neugut A.I. , Fehrenbacher L. , Thompson B. , Coronado G.D. .
Source: Breast Cancer Research And Treatment, 2012 Jan; 131(2), p. 607-17.
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Supplement Use And Risk Of Cutaneous Squamous Cell Carcinoma
Authors: Asgari M.M. , Chren M.M. , Warton E.M. , Friedman G.D. , White E. .
Source: Journal Of The American Academy Of Dermatology, 2011 Dec; 65(6), p. 1145-51.
PMID: 21664718
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Re: A Case-control Study Of Levothyroxine And The Risk Of Colorectal Cancer
Authors: Friedman G.D. , Schwalbe J.S. , Habel L.A. .
Source: Journal Of The National Cancer Institute, 2011-11-02 00:00:00.0; 103(21), p. 1637-9.
PMID: 22010174
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Examining The Influence Of Beta Blockers And Ace Inhibitors On The Risk For Breast Cancer Recurrence: Results From The Lace Cohort
Authors: Ganz P.A. , Habel L.A. , Weltzien E.K. , Caan B.J. , Cole S.W. .
Source: Breast Cancer Research And Treatment, 2011 Sep; 129(2), p. 549-56.
PMID: 21479924
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Norepinephrine Antagonists And Cancer Risk
Authors: Friedman G.D. , Udaltsova N. , Habel L.A. .
Source: International Journal Of Cancer, 2011-02-01 00:00:00.0; 128(3), p. 737-8; author reply 739.
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Association Of Tea Consumption And Cutaneous Squamous Cell Carcinoma
Authors: Asgari M.M. , White E. , Warton E.M. , Hararah M.K. , Friedman G.D. , Chren M.M. .
Source: Nutrition And Cancer, 2011; 63(2), p. 314-8.
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Lipophilic Statin Use And Risk Of Breast Cancer Subtypes
Authors: Woditschka S. , Habel L.A. , Udaltsova N. , Friedman G.D. , Sieh W. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2010 Oct; 19(10), p. 2479-87.
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Association Between Nonsteroidal Anti-inflammatory Drug Use And Cutaneous Squamous Cell Carcinoma
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Source: Archives Of Dermatology, 2010 Apr; 146(4), p. 388-95.
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Potential Risk Factors For Cutaneous Squamous Cell Carcinoma Include Oral Contraceptives: Results Of A Nested Case-control Study
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Source: International Journal Of Environmental Research And Public Health, 2010 Feb; 7(2), p. 427-42.
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Screening Pharmaceuticals For Possible Carcinogenic Effects: Initial Positive Results For Drugs Not Previously Screened
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Source: Cancer Causes & Control : Ccc, 2009 Dec; 20(10), p. 1821-35.
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Epidemiologic Evaluation Of Pharmaceuticals With Limited Evidence Of Carcinogenicity
Authors: Friedman G.D. , Jiang S.F. , Udaltsova N. , Quesenberry C.P. , Chan J. , Habel L.A. .
Source: International Journal Of Cancer, 2009-11-01 00:00:00.0; 125(9), p. 2173-8.
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Statin Use And Risk Of Colorectal Cancer In A Cohort Of Middle-aged Men In The Us: A Prospective Cohort Study
Authors: Flick E.D. , Habel L.A. , Chan K.A. , Haque R. , Quinn V.P. , Van Den Eeden S.K. , Sternfeld B. , Orav E.J. , Seeger J.D. , Quesenberry C.P. , et al. .
Source: Drugs, 2009-07-30 00:00:00.0; 69(11), p. 1445-57.
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Pharmaceuticals That Cause Mammary Gland Tumors In Animals: Findings In Women
Authors: Friedman G.D. , Jiang S.F. , Udaltsova N. , Chan J. , Quesenberry C.P. , Habel L.A. .
Source: Breast Cancer Research And Treatment, 2009 Jul; 116(1), p. 187-94.
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Statin Use And Risk Of Basal Cell Carcinoma
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Source: Journal Of The American Academy Of Dermatology, 2009 Jul; 61(1), p. 66-72.
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Erratum: Screening Statins For Possible Carcinogenic Risk: Up To 9 Years Of Follow-up Of 361 859 Recipients
Authors: Friedman G.D. , Flick E.D. , Udaltsova N. , Chan J. , Quesenberry C.P. , Habel L.A. .
Source: Pharmacoepidemiology And Drug Safety, 2008 Jul; 17(7), p. 751.
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Re: Declines In Invasive Breast Cancer And Use Of Postmenopausal Hormone Therapy In A Screening Mammography Population
Authors: Caan B. , Habel L. , Quesenberry C. , Kushi L. , Herrinton L. .
Source: Journal Of The National Cancer Institute, 2008-04-16 00:00:00.0; 100(8), p. 597-8; author reply 599.
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Screening Statins For Possible Carcinogenic Risk: Up To 9 Years Of Follow-up Of 361,859 Recipients
Authors: Friedman G.D. , Flick E.D. , Udaltsova N. , Chan J. , Quesenberry C.P. , Habel L.A. .
Source: Pharmacoepidemiology And Drug Safety, 2008 Jan; 17(1), p. 27-36.
PMID: 17944002
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Methylphenidate Use In Children And Risk Of Cancer At 18 Sites: Results Of Surveillance Analyses
Authors: Oestreicher N. , Friedman G.D. , Jiang S.F. , Chan J. , Quesenberry C. , Habel L.A. .
Source: Pharmacoepidemiology And Drug Safety, 2007 Dec; 16(12), p. 1268-72.
PMID: 18041106
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Statin Use And Risk Of Prostate Cancer In The California Men's Health Study Cohort
Authors: Flick E.D. , Habel L.A. , Chan K.A. , Van Den Eeden S.K. , Quinn V.P. , Haque R. , Orav E.J. , Seeger J.D. , Sadler M.C. , Quesenberry C.P. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2007 Nov; 16(11), p. 2218-25.
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Antibiotics And Risk Of Breast Cancer: Up To 9 Years Of Follow-up Of 2.1 Million Women
Authors: Friedman G.D. , Oestreicher N. , Chan J. , Quesenberry C.P. , Udaltsova N. , Habel L.A. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2006 Nov; 15(11), p. 2102-6.
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