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Research article:
Exposure to sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the QResearch primary care database
Reference:
Caroline Fairhurst, Ian Watt, Fabiola Martin, Martin Bland, and William J. Brackenbury(2014) Exposure to sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the QResearch primary care database. BMJ Open, doi:
- Link to fulltext article
- Abstract
- Introduction: Metastasis from solid tumours is associated with significant morbidity and mortality, and is the leading cause of cancer-related deaths. Voltage-gated sodium channels (VGSCs) are drug targets for the treatment of epilepsy. VGSCs are also present in cancer cells, where they regulate metastatic cell behaviours, including cellular movement and invasion. Treating cancer cells with the VGSC-inhibiting anticonvulsant phenytoin reduces cellular invasion and migration. Together, these suggest that VGSCs may be useful targets for inhibiting metastasis. The purpose of this study is to test the hypothesis that use of VGSC-inhibiting drugs will reduce metastasis, and therefore increase survival time in cancer patients. Methods and analysis: A cohort study based on primary care data from the QResearch database will include patients with one of three common tumours: breast, bowel, and prostate. The primary outcome will be overall survival from date of cancer diagnosis. Cox proportional hazards regression will be used to compare the survival of cancer patients taking VGSC-inhibiting drugs (including anticonvulsants and Class I antiarrhythmic agents) with cancer patients not exposed to these drugs, adjusting for age and sex. Exposure to VGSC-inhibiting drugs will be defined as having at least one prescription for these drugs prior to cancer diagnosis. High and low exposure groups will be identified based on length of use. A number of sensitivity and secondary analyses will be conducted. Ethics and dissemination: The protocol has been independently peer-reviewed and approved by the QResearch Scientific Board. The project has also been approved by the University of York Ethical Review Process. The results will be presented at international conferences and published in an open access peer-reviewed journal, in accordance with the STROBE criteria.
- Author for correspondence
- William J. Brackenbury
- Email for correspondence
- william.brackenbury@york.ac.uk
Code list: res17: Colorectal cancer
60 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| B13 | Read | Malignant neoplasm of colon | diagnostic | res17: Colorectal cancer | |||
| B130 | Read | Malignant neoplasm of hepatic flexure of colon | diagnostic | res17: Colorectal cancer | |||
| B130-99 | Read | Ca hepatic flexure - colon | diagnostic | res17: Colorectal cancer | |||
| B131 | Read | Malignant neoplasm of transverse colon | diagnostic | res17: Colorectal cancer | |||
| B131-99 | Read | Ca transverse colon | diagnostic | res17: Colorectal cancer | |||
| B132 | Read | Malignant neoplasm of descending colon | diagnostic | res17: Colorectal cancer | |||
| B132-99 | Read | Ca descending colon | diagnostic | res17: Colorectal cancer | |||
| B133 | Read | Malignant neoplasm of sigmoid colon | diagnostic | res17: Colorectal cancer | |||
| B133-99 | Read | Ca sigmoid colon | diagnostic | res17: Colorectal cancer | |||
| B134 | Read | Malignant neoplasm of caecum | diagnostic | res17: Colorectal cancer | |||
| B134-1 | Read | Carcinoma of caecum | diagnostic | res17: Colorectal cancer | |||
| B135 | Read | Malignant neoplasm of appendix | diagnostic | res17: Colorectal cancer | |||
| B136 | Read | Malignant neoplasm of ascending colon | diagnostic | res17: Colorectal cancer | |||
| B136-99 | Read | Ca ascending colon | diagnostic | res17: Colorectal cancer | |||
| B137 | Read | Malignant neoplasm of splenic flexure of colon | diagnostic | res17: Colorectal cancer | |||
| B137-99 | Read | Ca splenic flexure - colon | diagnostic | res17: Colorectal cancer | |||
| B138 | Read | Malignant neoplasm, overlapping lesion of colon | diagnostic | res17: Colorectal cancer | |||
| B139 | Read | Hereditary nonpolyposis colon cancer | diagnostic | res17: Colorectal cancer | |||
| B13y | Read | Malignant neoplasm of other specified sites of colon | diagnostic | res17: Colorectal cancer | |||
| B13z | Read | Malignant neoplasm of colon NOS | diagnostic | res17: Colorectal cancer | |||
| B13z-1 | Read | Colonic cancer | diagnostic | res17: Colorectal cancer | |||
| B14 | Read | Malignant neoplasm of rectum, rectosigmoid junction and anus | diagnostic | res17: Colorectal cancer | |||
| B140 | Read | Malignant neoplasm of rectosigmoid junction | diagnostic | res17: Colorectal cancer | |||
| B140-99 | Read | Ca rectosigmoid junction | diagnostic | res17: Colorectal cancer | |||
| B141 | Read | Malignant neoplasm of rectum | diagnostic | res17: Colorectal cancer | |||
| B141-1 | Read | Carcinoma of rectum | diagnostic | res17: Colorectal cancer | |||
| B141-2 | Read | Rectal carcinoma | diagnostic | res17: Colorectal cancer | |||
| B141-99 | Read | Adenocarcinoma of rectum | diagnostic | res17: Colorectal cancer | |||
| B1420 | Read | Malignant neoplasm of cloacogenic zone | diagnostic | res17: Colorectal cancer | |||
| B143 | Read | Malignant neoplasm of anus unspecified | diagnostic | res17: Colorectal cancer | |||
| B14-99 | Read | Ca rectum + Ca anus | diagnostic | res17: Colorectal cancer | |||
| B14y | Read | Malig neop other site rectum, rectosigmoid junction and anus | diagnostic | res17: Colorectal cancer | |||
| B14z | Read | Malignant neoplasm rectum,rectosigmoid junction and anus NOS | diagnostic | res17: Colorectal cancer | |||
| B14z-99 | Read | Ca rectum + Ca anus NOS | diagnostic | res17: Colorectal cancer | |||
| B1z0-1 | Read | Cancer of bowel | diagnostic | res17: Colorectal cancer | |||
| B575 | Read | Secondary malignant neoplasm of large intestine and rectum | diagnostic | res17: Colorectal cancer | |||
| B5750 | Read | Secondary malignant neoplasm of colon | diagnostic | res17: Colorectal cancer | |||
| B5751 | Read | Secondary malignant neoplasm of rectum | diagnostic | res17: Colorectal cancer | |||
| B575z | Read | Secondary malig neop of large intestine or rectum NOS | diagnostic | res17: Colorectal cancer | |||
| B803 | Read | Carcinoma in situ of colon | diagnostic | res17: Colorectal cancer | |||
| B8030 | Read | Carcinoma in situ of hepatic flexure of colon | diagnostic | res17: Colorectal cancer | |||
| B8031 | Read | Carcinoma in situ of transverse colon | diagnostic | res17: Colorectal cancer | |||
| B8032 | Read | Carcinoma in situ of descending colon | diagnostic | res17: Colorectal cancer | |||
| B8033 | Read | Carcinoma in situ of sigmoid colon | diagnostic | res17: Colorectal cancer | |||
| B8036 | Read | Carcinoma in situ of ascending colon | diagnostic | res17: Colorectal cancer | |||
| B8037 | Read | Carcinoma in situ of splenic flexure of colon | diagnostic | res17: Colorectal cancer | |||
| B8038 | Read | High grade dysplasia of colon | diagnostic | res17: Colorectal cancer | |||
| B803z | Read | Carcinoma in situ of colon NOS | diagnostic | res17: Colorectal cancer | |||
| B804 | Read | Carcinoma in situ of rectum and rectosigmoid junction | diagnostic | res17: Colorectal cancer | |||
| B8040 | Read | Carcinoma in situ of rectosigmoid junction | diagnostic | res17: Colorectal cancer | |||
| B8041 | Read | Carcinoma in situ of rectum | diagnostic | res17: Colorectal cancer | |||
| B804z | Read | Carcinoma in situ of rectum or rectosigmoid junction NOS | diagnostic | res17: Colorectal cancer | |||
| B902 | Read | Neop of uncertain behaviour stomach, intestines and rectum | diagnostic | res17: Colorectal cancer | |||
| B9024 | Read | Neoplasm of uncertain behaviour of colon | diagnostic | res17: Colorectal cancer | |||
| B9025 | Read | Neoplasm of uncertain behaviour of rectum | diagnostic | res17: Colorectal cancer | |||
| B902z | Read | Neop of uncertain behaviour stomach, intestine or rectum NOS | diagnostic | res17: Colorectal cancer | |||
| BB5N | Read | [M]Adenomatous and adenocarcinomatous polyps of colon | diagnostic | res17: Colorectal cancer | |||
| EGTON2B152 | Read | Cause of Death- Ca Rectum | diagnostic | res17: Colorectal cancer | |||
| EMISNQHE41 | Read | Hereditary nonpolyposis colon cancer | diagnostic | res17: Colorectal cancer | |||
| HNG0201 | Read | [RFC] Cancer of the rectum | diagnostic | res17: Colorectal cancer |
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