Do drug therapies raise risk of bladder cancer?

In her most recent study of possible triggers of cancer among northern New England residents, Dartmouth epidemiologist Margaret R. Karagas, Ph.D., and her team identified an enhanced risk to the bladders of patients taking drugs that suppress the immune system.

The findings, from a population-based, case-control study in New Hampshire, appear in the September 2009 issue of the British Journal of Cancer, with Dartmouth Medical School student Karl Dietrich as first author, with DMS professors Alan R. Schned, M.D., and John A. Heaney, M.D., as co-authors, and with Karagas, a professor of community and family medicine at DMS, as principal investigator.

The report examines the long-term use of glucocorticoids by 786 bladder-cancer patients and by 1,083 control subjects. Doctors commonly prescribe a combination of cytotoxic drugs and glucocorticoids as immunosuppressive therapy to help recipients of transplants avoid rejection of their new organs, and patients with rheumatoid arthritis, asthma, and other conditions often take glucocorticoids. Previous research, in some of which Karagas participated, has shown associations between such drug therapies and higher risk of skin cancer and lymphoma. A similar risk for bladder cancer, the new report says, “might indicate the need for closer monitoring of individuals who regularly take glucocorticoids.”

In addition to teaching epidemiology, Karagas is section head of biostatistics and epidemiology at DMS, and co-director of the Norris Cotton Cancer Center's epidemiology and chemoprevention program. Schned is a professor of pathology and acting chair of that department at the medical school, where Heaney is a professor of surgery specializing in urology.

The journal article can be viewed here (http://www.nature.com/bjc/journal/v101/n8/full/6605314a.html)