Methylphenidate use in children and risk of cancer at 18 sites: results of surveillance analyses.
Methylphenidate use in children and risk of cancer at 18 sites: results of surveillance analyses.
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儿童使用哌甲酯和 18 个地点的癌症风险：监测分析结果。
DOI：
10.1002/pds.1519
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发表时间：
2007
影响因子：
2.6
通讯作者：
Habel,LaurelA
中科院分区：
文献类型：
--
作者：
Oestreicher,Nina;Friedman,GaryD;Jiang,Sheng-Fang;Chan,Jim;QuesenberryJr,Charles;Habel,LaurelA
目的最近的一份报告将儿童使用哌醋甲酯(MPH)与血浆淋巴细胞的细胞学异常联系在一起，血浆淋巴细胞可能是一种癌症生物标志物。这项研究的目的是调查使用公共卫生与儿童癌症风险的关系。方法使用自动药房数据库和凯撒永久医疗保健计划(KPMCP)与SEER相关的癌症登记，我们比较了在20岁之前接受公共卫生服务的35 400英里/小时使用者中18个地点的癌症发病率与KPMCP成员中的癌症发病率(年龄、性别和日历年标准化)。结果在公共卫生服务使用者中有23人患癌症，比预期的20.4(标准化发病率比，SMR = 1.13，95%可信区间(0.72，1.7))。考虑到癌症的数量很少，特定部位的SMR估计是不准确的。在P<； 水平上，只有一个SMR具有统计学意义，考虑到比较的次数，这与任何地点都没有真正的关联是一致的。使用MPH与淋巴细胞性白血病风险增加相关(基于8个观察病例，SMR = 为2.64(1.14，5.20))。这些暴露病例的医疗记录没有显示任何淋巴细胞白血病的危险因素(既往癌症、放疗或化疗或唐氏综合征)。结论我们的结果与使用MPH与儿童癌症风险之间没有中度或强烈的关联，尽管我们检查特定部位的剂量和使用时间或风险的能力受到少数人的限制。还需要进一步研究PMH的使用和淋巴细胞性白血病的风险，以确定我们的结果是否仅仅是偶然的。版权所有©2007 John Wiley&Sons，Ltd.
PurposeA recent report linked methylphenidate (MPH) use in children to cytologic abnormalities in plasma lymphocytes, a possible cancer biomarker. The purpose of this study was to investigate the association of MPH use and childhood cancer risk.MethodsUsing automated pharmacy databases and the SEER‐affiliated cancer registry of the Kaiser Permanente Medical Care Program (KPMCP), we compared cancer rates at 18 sites among 35 400 MPH users who received it before age 20 to rates among KPMCP membership (age, sex, and calendar year standardized). Medical records of MPH exposed cancer cases were reviewed to identify the presence of established risk factors.ResultsThere were 23 cancers among MPH users,versus20.4 expected (standardized morbidity ratio, SMR = 1.13, 95% confidence interval (0.72, 1.70)). Given the small number of cancers, site‐specific SMR estimates were imprecise. Only one SMR was statistically significant at thep< 0.05 level, which given the number of comparisons is consistent with the absence of a true association at any site. MPH use was associated with increased risk of lymphocytic leukemia (SMR = 2.64 (1.14, 5.20)), based on eight observed cases). The medical records of these exposed cases did not reveal any lymphocytic leukemia risk factors (prior cancer, radiotherapy or chemotherapy, or Down syndrome).ConclusionsOur results are consistent with no moderate or strong association between MPH use and cancer risk in children, although our ability to examine dose and duration of use or risk at specific sites was limited by small numbers. Further study of MPH use and lymphocytic leukemia risk is needed to determine whether our results are due to chance alone. Copyright © 2007 John Wiley & Sons, Ltd.