STUDIES OF DRUG-INDUCED CANCER AND MULTIPLE PRIMARY CANCERS

该项目的目的是研究长期的健康影响， 药物，特别是治疗剂，因为它们可能涉及 致癌性 此外，发生多个事件的模式 原发性癌症的评估是根据病因学的影响， research. 因为许多关于辐射致癌的研究都涉及到 对原发性癌症进行放射治疗后的第二种癌症的评估， 同时评估以下因素的影响往往是方便的： 化疗剂。 研究人群包括接受以下治疗的患者： 随机临床试验，患者报告癌症登记处， 美国和其他国家，并在几个大型 机构职能体系 除了对治疗药物进行系统研究外， 偶尔也有可能评估人群中的其他药物暴露 研究其他原因。 环己亚硝脲甲脂辅助治疗慢性乙型肝炎的临床研究 胃肠道癌症提供了明确的剂量反应证据， 亚硝基脲类药物可引起人类白血病。治疗儿童白血病的烷化剂 癌症与白血病和骨癌的风险增加有关。 接受化疗的乳腺癌妇女的风险增加 白血病 在卵巢癌患者中， 白血病的发生率是环磷酰胺的三倍 通常 没有发现使用的药物与甲状腺癌有关。 癌症患者 在30岁以下的人中， 幸存者 吸烟可能与宫颈癌有因果关系。

The purpose of this project is to study the long-term health effects of drugs, especially therapeutic agents, as they may relate to carcinogenicity. In addition, the patterns of occurrence of multiple primary cancer are evaluated in terms of implications for etiologic research. Because many studies of radiation carcinogenesis involve the evaluation of second cancers following radiotherapy for a primary cancer, it is often convenient to evaluate, simultaneously, the effects of chemotherapeutic agents. Populations studied include patients treated in randomized clinical trials, patients reported to cancer registries in the United States and other countries, and patients treated at several large institutions. In addition to the systematic study of therapeutic drugs, occasionally it is possible to evaluate other drug exposures in populations studied for other reasons. A study of patients given methyl-CCNU as adjuvant therapy for gastrointestinal cancer provided clear dose-response evidence that nitrosoureas are leukemogenic in man. Alkylating agents to treat childhood cancer were associated with an increased risk of leukemia and bone cancer. Women with breast cancer who received chemotherapy are at an increased risk of leukemia. Among ovarian cancer patients, treatment with melphalan appears three times more leukemogenic than with cyclophosphamide. Commonly used drugs were not found to be related to thyroid cancer. Cancer patients have a 31% increased risk of developing a second primary 49% among 30-year survivors. Smoking may be causally related to cervical cancer.