Little is known about the effect of systemic glucocorticoids and whether there is an association with the development of colorectal cancer. Previous studies have evaluated glucocorticoid therapy and colorectal cancer risk in patients with inflammatory bowel disease, who have an increased risk of cancer because of their disease.
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To investigate, researchers conducted a large prospective nested population-based case?control study in Denmark examining this association, both overall and according to cancer stage.
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The Danish Cancer Registry identified 14,158 patients with a first-time diagnosis of colorectal cancer from 1991 through 2010. For each colorectal cancer case, the Danish Civil Registration System was used to select 10 population controls matched on age and gender. For each case and control, the researchers identified all dispensed prescriptions of glucocorticoids prior to the index date.
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The following findings were reported:
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??Frequent use of systemic glucocorticoids (defined as >2 prescriptions) was not associated with overall colorectal cancer risk [adjusted OR (aOR) = 0.93 (95% CI: 0.85?1.00)], compared with never/rare use (?2 prescriptions).
??Associations according to duration of use and doses (quartiles of cumulative prednisolone equivalents) were also near the null.
??Examining colorectal cancer by stage, no substantial associations were found between long-term use (>5 years) of high-dose (>5500 mg) systemic glucocorticoids and localised [aOR = 1.12 (95% CI: 0.81?1.55)] or metastatic [aOR = 0.82 (95% CI: 0.59?1.14)] cancer.
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The authors concluded that they found no evidence of an overall association between frequent use of systemic glucocorticoids and colorectal cancer risk. They note that although results were close to null, long-term use of medium- or high-dose systemic glucocorticoids slightly increased risk of localised colorectal cancer, and decreased risk of metastatic cancer.
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