Incidence and prevalence of drugs used for chronic diseases in survivors of adult-onset gynaecological cancer - A nationwide cohort study

BJOG. 2023 Jun;130(7):770-778. doi: 10.1111/1471-0528.17410. Epub 2023 Feb 15.

Abstract

Objectives: To evaluate both incidence and prevalence of drugs used for chronic diseases in survivors of adult-onset gynaecological cancer.

Design: A prospective study.

Setting: Population-based registries.

Population: 1.76 million women, including 17 500 women with gynaecological cancers.

Methods: Data from the Cancer Registry of Norway was linked to the Norwegian Prescription Database and other national databases.

Main outcome measures: Prevalence ratios (PRs) and hazard ratios (HRs), with 95% confidence intervals (CIs), of dispensed drugs in gynaecological cancer patients (up to 15 years after diagnosis) were estimated by log-binomial and Cox regression, respectively, with cancer-free women as reference.

Results: For gynaecological cancer patients, the incidence of drugs used for pain control was higher than in cancer-free women, especially the first 5 years after diagnosis, and the prevalence was high at least 10 years after. The prevalence of sex hormones was high in women with gynaecological cancer at least 10 years after diagnosis (cervical and ovarian cancer PR = 23, 95% CI 18-30 and PR = 29, 95% CI 15-38, respectively), but low in cancer-free women (0.3%). Patients with uterine corpus cancer had a higher prevalence of antidiabetics before and at least 10 years after diagnosis, most pronounced in women diagnosed before age 50 (PR = 10, 95% CI 5.0-21). The prevalence of antidepressants was moderately elevated in women with gynaecological cancers.

Conclusions: Gynaecological cancer survivors, particularly cervical and ovarian cancer survivors, had an increased long-term use of drugs for pain control and sex hormones. Survivors of uterine corpus cancer used antidiabetics more often, both before and after diagnosis.

Keywords: cervical cancer; chronic diseases; drugs; medication; ovarian cancer; pharmacoepidemiology; population-based; uterine corpus cancer.

MeSH terms

  • Adult
  • Chronic Disease
  • Cohort Studies
  • Female
  • Genital Neoplasms, Female* / drug therapy
  • Genital Neoplasms, Female* / epidemiology
  • Humans
  • Incidence
  • Middle Aged
  • Ovarian Neoplasms* / epidemiology
  • Pain
  • Prevalence
  • Prospective Studies
  • Survivors
  • Uterine Neoplasms* / drug therapy
  • Uterine Neoplasms* / epidemiology