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Barbiturates and lung cancer: a re-evaluation.
1Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA, USA. gdf@dor.kaiser.org
International Journal of Epidemiology
|July 16, 1999
Summary
Barbiturates, like phenobarbital, may increase lung cancer risk, particularly in women non-smokers. This association, possibly due to tumor promotion, persists even after accounting for smoking. Further research is needed for conclusive evidence.
Area of Science:
- Pharmacology and Oncology
- Epidemiology and Public Health
Background:
- Barbiturates, particularly phenobarbital, are suspected tumor promoters.
- Previous studies indicated an association between barbiturate use and increased lung cancer risk.
Purpose of the Study:
- To further evaluate the association between barbiturate use and lung cancer risk with extended follow-up.
- To investigate potential dose-response relationships and the influence of cigarette smoking.
Main Methods:
- A cohort of 10,213 Kaiser Permanente members who used barbiturates (1969-1973) were followed up to 1992.
- Lung cancer incidence was compared to the general pharmacy cohort (143,594), with adjustments for smoking habits.
Main Results:
- An elevated lung cancer risk (Standard Morbidity Ratio ~1.3) associated with barbiturates persisted over 23 years.
- A dose-response trend was observed, and the association was not fully explained by cigarette smoking.
- Adenocarcinoma in women who never smoked appeared most affected.
Conclusions:
- The findings strengthen the evidence for a barbiturate-lung cancer association, likely involving tumor promotion.
- The association may be more pronounced in women, particularly with adenocarcinoma, and is not solely due to smoking.
- Conclusive evidence is limited by the small number of lung cancer cases among never-smokers.