Table 2.
Associations between acetaminophen use and cancer incidence, stratified by cancer site and gender
| 10-year Use Prior to Baselinea | ||||
|---|---|---|---|---|
| Cancer Siteb | No Use | Low Use | High Use | P trend |
| Gastrointestinal (n=783)1 | ||||
| Cases / Non-cases | 623 / 48,311 | 120 / 10,529 | 40 / 3,218 | |
| HR (95% CI)c | 1.00 (reference) | 0.90 (0.71–1.14) | 0.84 (0.57–1.22) | 0.24 |
| Women | ||||
| Cases / Non-cases | 265 / 23,096 | 72 / 6,453 | 20 / 2,153 | |
| HR (95% CI)c | 1.00 (reference) | 0.93 (0.67–1.29) | 0.75 (0.45–1.26) | 0.29 |
| Men | ||||
| Cases / Non-cases | 358 / 25,215 | 48 / 4,076 | 20 / 1,065 | |
| HR (95% CI)c | 1.00 (reference) | 0.86 (0.60–1.23) | 0.94 (0.54–1.64) | 0.53 |
| P interaction = 0.35 | ||||
| Colon and rectum (n=419) | ||||
| Cases / Non-cases | 344 / 48,590 | 56 / 10,593 | 19 / 3,239 | |
| HR (95% CI)c | 1.00 (reference) | 0.79 (0.56–1.12) | 0.80 (0.46–1.37) | 0.18 |
| Pancreas (n=132) | ||||
| Cases / Non-cases | 105 / 48,829 | 21 / 10,628 | 6 / 3,252 | |
| HR (95% CI)c | 1.00 (reference) | 0.90 (0.51–1.58) | 0.40 (0.12–1.31) | 0.16 |
| Lung (n=622) | ||||
| Cases / Non-cases | 458 / 48,476 | 122 / 10,527 | 42 / 3,216 | |
| HR (95% CI)c | 1.00 (reference) | 1.22 (0.95–1.55) | 1.06 (0.73–1.54) | 0.32 |
| Women | ||||
| Cases / Non-cases | 170 / 23,191 | 67 / 6,458 | 28 / 2,145 | |
| HR (95% CI)c | 1.00 (reference) | 1.18 (0.83–1.67) | 1.18 (0.72–1.95) | 0.36 |
| Men | ||||
| Cases / Non-cases | 288 / 25,285 | 55 / 4,069 | 14 / 1,071 | |
| HR (95% CI)c | 1.00 (reference) | 1.24 (0.88–1.75) | 0.93 (0.52–1.67) | 0.64 |
| P interaction = 0.65 | ||||
| Urinary tract (n=282)2 | ||||
| Cases / Non-cases | 214 / 48,720 | 50 / 10,599 | 18 / 3,240 | |
| HR (95% CI)c | 1.00 (reference) | 1.10 (0.76–1.59) | 1.05 (0.60–1.83) | 0.72 |
| Women | ||||
| Cases / Non-cases | 57 / 23,304 | 21 / 6,504 | 8 / 2,165 | |
| HR (95% CI)c | 1.00 (reference) | 1.07 (0.58–1.97) | 0.89 (0.38–2.11) | 0.89 |
| Men | ||||
| Cases / Non-cases | 157 / 25,416 | 29 / 4,095 | 10 / 1,075 | |
| HR (95% CI)c | 1.00 (reference) | 1.17 (0.73–1.87) | 1.15 (0.54–2.41) | 0.53 |
| P interaction = 0.88 | ||||
| Kidney (n=161) | ||||
| Cases / Non-cases | 120 / 48,814 | 30 / 10,619 | 11 / 3,247 | |
| HR (95% CI)c | 1.00 (reference) | 1.11 (0.69–1.79) | 0.96 (0.46–1.98) | 0.91 |
| Bladder (n=101) | ||||
| Cases / Non-cases | 76 / 48,858 | 19 / 10,630 | 6 / 3,252 | |
| HR (95% CI)c | 1.00 (reference) | 1.39 (0.74–2.60) | 1.50 (0.57–3.89) | 0.24 |
| Melanoma (n=279) | ||||
| Cases / Non-cases | 229 / 48,705 | 38 / 10,611 | 12 / 3,246 | |
| HR (95% CI)c | 1.00 (reference) | 0.90 (0.60–1.33) | 0.79 (0.39–1.58) | 0.42 |
| Women | ||||
| Cases / Non-cases | 84 / 23,277 | 17 / 6,508 | 6 / 2,167 | |
| HR (95% CI)c | 1.00 (reference) | 0.76 (0.42–1.39) | 0.63 (0.22–1.82) | 0.26 |
| Men | ||||
| Cases / Non-cases | 145 / 25,428 | 21 / 4,103 | 6 / 1,079 | |
| HR (95% CI)c | 1.00 (reference) | 1.02 (0.61–1.71) | 1.04 (0.41–2.62) | 0.92 |
| P interaction = 0.33 | ||||
| Female cancers (n=1,225)3 | ||||
| Cases / Non-cases | 880 / 22,481 | 269 / 6,256 | 70 / 2,103 | |
| HR (95% CI)c | 1.00 (reference) | 1.07 (0.91–1.26) | 0.85 (0.64–1.13) | 0.68 |
| Breast (n=901) | ||||
| Cases / Non-cases | 646 / 22,715 | 196 / 6,329 | 53 / 2,120 | |
| HR (95% CI)c | 1.00 (reference) | 1.10 (0.91–1.33) | 0.83 (0.59–1.15) | 0.74 |
| Uterus (n=214) | ||||
| Cases / Non-cases | 156 / 23,205 | 47 / 6,478 | 11 / 2,162 | |
| HR (95% CI)c | 1.00 (reference) | 1.07 (0.71–1.63) | 0.99 (0.48–2.01) | 0.88 |
| Prostate cancer (n=1,587) | ||||
| Cases / Non-cases | 1,321 / 24,252 | 216 / 3,908 | 50 / 1,035 | |
| HR (95% CI)c | 1.00 (reference) | 1.10 (0.93–1.30) | 1.00 (0.73–1.37) | 0.51 |
| Aggressive prostate cancer (n=768)d | ||||
| Cases / Non-cases | 649 / 48,285 | 99 / 10,550 | 20 / 3,238 | |
| HR (95% CI)c | 1.00 (reference) | 0.97 (0.76–1.25) | 0.74 (0.45–1.21) | 0.32 |
Low use, use for either less than 4 days/week or less than 4 years; high use, use for at least 4 days/week and at least 4 years.
Major categories do not add to 5,750 due to exclusion of 571 cases with hematologic malignancies and 393 cases with cancers of the head and neck, connective tissue, brain, thyroid, and unspecified primary site.
All models were adjusted as described in footnote to Table 1.
To compare our findings on prostate cancer risk with those from Jacobs et al. (8), we considered aggressive prostate cancers to be those with a Gleason grade ≥7, AJCC stages III/IV, or fatal prostate cancer. For cancers diagnosed between 2000 and 2003, Gleason grade was identified using a SEER differentiation variable. From 2000 to 2002, well or moderately differentiated tumors were those with Gleason grades of 2 to 7, while poorly differentiated tumors had scores between 8 and 10. In 2003, this coding scheme changed so that a Gleason grade of 7 was considered poorly differentiated. We therefore re-abstracted Gleason scores from the original SEER reports for cancers diagnosed from 2000 to 2002 in order to properly classify Gleason grades of ≥7 as poorly differentiated. AJCC stage was not available from SEER until 2004. Before 2004, we classified aggressive tumors as those with distant SEER summary stage, which identifies metastatic AJCC stage IV tumors. Prostate cancers diagnosed from 2004 to 2008 were classified as aggressive using Gleason grade (≥7) and AJCC stage (III/IV) data. Fatal prostate cancer was defined by cause of death and was available for all years.
Besides cancers of colon/rectum and pancreas, contains cancers of esophagus (n=56), stomach (n=56), liver (n=47), small intestines (n=21), anus and anal canal (n=15), gall bladder (n=11), biliary tract (n=9), and other or ill-defined digestive organs (n=17).
Besides cancers of kidney and bladder, contains cancers of renal pelvis (n=10), ureter (n=5), and other or unspecified urinary organs (n=5).
Besides cancers of breast and uterus, contains cancers of ovary (n=74), cervix (n=11), vulva (n=7), vagina (n=3), and other or unspecified female genital organs (n=15).
Abbreviations: CI, confidence interval; HR, hazard ratio.