Long-term use of anti-cholesterol drugs and cancer risks in a Japanese population.

Several studies have investigated the association between the use of anti-cholesterol drugs and cancer risks, of which results have been inconsistent. This study included 67,768 participants from the Japan Public Health Center-based Prospective Study. The data on anti-cholesterol drug use was collected using three questionnaires of the survey conducted every five years. We divided the participants into three groups according to the duration of the anti-cholesterol drug use. Multivariable-adjusted Cox proportional hazard regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). During the 893,009 person-years of follow-up from the 10-year follow-up survey, 8,775 participants (5,387 men and 3,388 women) were newly diagnosed with cancers. The duration of anti-cholesterol drug use was significantly associated with a decreased risk of liver cancer (HR:0.26, 95% CI 0.11-0.64 in > 5 y group) and with an increased risk of pancreatic cancer (HR:1.59, 95% CI 1.03-2.47 in > 5 y group). Moreover, a different trend was observed between men and women in the association with the risk of lung cancer. This study suggested that long-term use of anti-cholesterol drugs may have associations with a decreased incidence of liver cancer and with an increased incidence of pancreatic cancers.

Association of anticholinergic drug exposure with the risk of dementia among older adults in Japan: The LIFE Study.

OBJECTIVES: Several studies have investigated that anticholinergic drugs cause cognitive impairment. However, the risk of dementia associated with anticholinergics has not been extensively investigated in the super-aging society of Japan. We conducted this study to assess the association between anticholinergic drugs and the risk of dementia in older adults in Japan. METHODS: This nested case-control study used data from the Longevity Improvement & Fair Evidence Study, which includes claim data in Japan from 2014 to 2020. We included 66,478 cases of diagnosed dementia and 328,919 matched controls aged ≥65 years, matched by age, sex, municipality, and cohort entry year. Primary exposure was the total cumulative anticholinergic drugs prescribed from cohort entry date to event date or matched index date, which was the total standardized daily doses for each patient, calculated by adding the total dose of different types of anticholinergic drugs in each prescription, divided by the World Health Organization-defined daily dose values. Odds ratios for dementia associated with cumulative exposure to anticholinergic drugs were calculated using conditional logistic regression adjusted for confounding variables. RESULTS: The mean (standard deviation) age at index date was 84.3 (6.9), and the percentage of women was 62.1%. From cohort entry date to event date or matched index date, 18.8% of the case patients and 13.7% of the controls were prescribed at least one anticholinergic drug. In the multivariable-adjusted model, individuals with anticholinergic drugs prescribed had significantly higher odds of being diagnosed with dementia (adjusted odds ratio, 1.50 [95% confidence interval, 1.47-1.54]). Among specific types of anticholinergic drugs, a significant increase in risk was observed with the use of antidepressants, antiparkinsonian drugs, antipsychotics, and bladder antimuscarinics in a fully multivariable-adjusted model. CONCLUSIONS: Several types of anticholinergic drugs used by older adults in Japan are associated with an increased risk of dementia. These findings suggest that the underlying risks should be considered alongside the benefits of prescribing anticholinergic drugs to this population.

Association Between Alcohol Consumption and Risk of Pancreatic Cancer: The Japan Public Health Center-Based Prospective Study.

BACKGROUND: Several studies have investigated the association between alcohol consumption and pancreatic cancer risk. However, these studies reported inconsistent results. METHODS: This study included 95,812 participants from the Japan Public Health Center-Based Prospective Study, whose alcohol drinking habit was collected through the questionnaire of the baseline survey in 1990 to 1994 for Cohort I and in 1993 to 1995 for Cohort II, and followed-up until December 2013. The hazard ratios (HR) and 95% confidence intervals (CI) were calculated using multivariable-adjusted Cox proportional hazard regression models. RESULTS: During 1,969,101 person-years of follow-up, 598 patients (315 men and 283 women) were newly diagnosed with pancreatic cancer. No association was observed between alcohol consumption at baseline and pancreatic cancer risk in either men or women, even in the analyses conducted among men stratified by facial flushing responses or smoking status. When the population was limited to men whose alcohol drinking habit remained unchanged from the baseline survey to the 5-year follow-up survey, a significant association was observed in drinkers with alcohol consumption of 1 to 299 g/week compared with non/occasional drinkers (multivariable-adjusted HR, 1.73; 95% CI, 1.15-2.60). CONCLUSIONS: A significant association between alcohol consumption and pancreatic cancer risk was observed when the population was limited to men with a 5-year unchanged alcohol drinking habit and was particularly strong in never smokers. IMPACT: This study suggested an association between continuous alcohol consumption and pancreatic cancer risk in the Japanese population. However, further investigations using other cohort studies are required.