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. 2019 Jan 23:11:133-143.
doi: 10.2147/CLEP.S186842. eCollection 2019.

Exposure to antimuscarinic medications for treatment of overactive bladder and risk of lung cancer and colon cancer

Lukas Löfling  1 , Anders Sundström  1 , Helle Kieler  1 , Shahram Bahmanyar  1 , Marie Linder  1
Affiliations

Exposure to antimuscarinic medications for treatment of overactive bladder and risk of lung cancer and colon cancer

Lukas Löfling et al. Clin Epidemiol. .

Abstract

Introduction: One out of six adults has symptoms of overactive bladder (OAB). Antimuscarinic medication is the main pharmacological group used in the treatment of OAB. In preclinical studies, antimuscarinic compounds have been found to inhibit cell proliferation in lung cancer and colon cancer.

Objective: The aim of this study was to investigate the association between exposure to anti-muscarinic medication and the risk of lung cancer and colon cancer.

Methods: Individuals in Sweden who first filled a prescription for an antimuscarinic medication used to treat OAB (ie, oxybutynin, solifenacin, darifenacin, fesoterodine, or tolterodine) between July 1, 2006, and December 31, 2012, were identified and classified as exposed. Each exposed individual was individually matched with up to ten unexposed individuals from the Swedish general population, based on year of birth, sex, and county of residence. Cox proportional hazard models with follow-up time as the underlying time scale were used to estimate HRs with 95% CIs.

Results: In total, 164,000 exposed and 1,446,472 unexposed individuals were included in this study. The estimated HRs for lung cancer, in follow-up time intervals of <1 year, 1-4 years, and ≥4 years, were as follows: 0.86 (95% CI: 0.75-0.98), 0.63 (95% CI: 0.56-0.70), and 0.43 (0.34-0.55), respectively. The corresponding estimates for colon cancer were as follows: 0.91 (95% CI: 0.80-1.03), 0.81 (95% CI: 0.74-0.88), and 0.61 (95% CI: 0.51-0.73), respectively.

Conclusion: There was an inverse association between exposure to antimuscarinic medications, used in the treatment of OAB, and a diagnosis of colon cancer or lung cancer, which is in line with the findings in preclinical studies.

Keywords: antimuscarinic medications; colon cancer; lung cancer; overactive bladder.

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Conflict of interest statement

Disclosure All the authors are employees of the Centre for Pharmacoepidemiology at Karolinska Institutet, which receives grants from several funding bodies for the performance of drug safety and drug utilization studies. These funding bodies had no role in the data collection and analysis and were not involved in the interpretation of results, writing, revision, or approval of the manuscript. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Inclusion of study population to the study cohort.
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