Cancer risk associated with long-term use of acetaminophen in the prospective VITamins And Lifestyle (VITAL) study
Cette étude de cohorte américaine incluant 62 841 participants âgés de 50 à 76 ans analyse l'association entre la prise à long terme de paracétamol et le risque de cancer
Background: Acetaminophen (paracetamol) is a widely used over-the-counter drug, but concerns of genotoxic effects have been raised. After we recently found an almost 2-fold increased risk of hematologic malignancies associated with high use of acetaminophen in the prospective VITamins And Lifestyle (VITAL) study, we herein further examined the association between acetaminophen and cancer risk in the VITAL cohort. Methods: 62,841 men and women aged 50 to 76 years were recruited from 2000-2002, and incident malignancies other than non-melanoma skin cancer (n=5,750) were identified through December 2008 via linkage to the Surveillance, Epidemiology, and End Results cancer registry. Hazards ratios associated with acetaminophen use for incidence of total cancers and non-hematologic cancer subcategories were estimated with Cox proportional hazards models that were adjusted for age, demographics, cancer risk factors, and medical conditions that may be indications for acetaminophen use. Results: Use of acetaminophen was not associated with total cancer risk. We also observed no associations for most major non-hematologic cancer sites, including cancers of the gastrointestinal system, lung, urinary tract, skin, prostate, or female organs. Conclusion: This study failed to provide evidence of an association between acetaminophen use and total cancer risk and incidence of non-hematologic malignancies. Impact: Together with our previous findings, the findings from the VITAL study suggest a particular sensitivity of the hematopoietic system to the mutagenic effects of acetaminophen.