Approved research

The role of commonly used medications and supplements in cancer prevention and survival

Lay summary

Questions: 1) Commonly used medications and supplements in association with cancer risk (overall and site-specific). 2) Commonly used medications and supplements in association with cancer survival (overall and site-specific). We will explore associations by factors such as age, sex, BMI, and genetics (i.e., genetic factors related to given condition and/or related to metabolism of the drug or supplement of interest). We will explore the mechanisms by which drugs and supplements may affect cancer using mediation methods to quantify the magnitude to which associations are driven by circulating biomarkers (e.g., inflammation, insulin resistance, sex steroids). Identifying easily modifiable and cost-effective strategies to prevent cancer and improve cancer survival is an important challenge. It is also critically important that we identify drugs and supplements that are adversely associated with cancer risk and survival. This research, which addresses an important public health question, aligns with the UK Biobank?s core purpose. To comprehensively explore how medications commonly used to treat chronic conditions (such as diabetes and cardiovascular conditions) as well as supplements affect cancer risk and survival, we propose to examine these relationships in the UK Biobank cohort. This population will allow for adequate statistical power to uncover and characterize medications associated with cancer and enable analyses of both cancer development and survival. In addition, the large sample size and availability of biomarkers will facilitate exploratory mediation analyses to uncover the biology underlying any identified relationships, and to evaluate whether certain pharmacologic agents have stronger associations in subsets of individuals. We will use data from the full UK Biobank cohort of 500,000 individuals. For each medication, however, we will include only individuals diagnosed with the condition indicating the use of that particular drug (e.g., for Metformin, we will include individuals diagnosed with diabetes). Analyses of cancer risk will include all individuals with no prior history of cancer. Analyses of cancer survival will evaluate the subset of participants diagnosed with cancer (N~80,000), and restricted to persons with no cancer history prior to baseline to capture survival after the first invasive cancer.