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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: Smoking status

102 codes in list

Code Coding system Description Entity type List name
1371 Read Never smoked tobacco test res17: Smoking status
137-1 Read Smoker - amount smoked test res17: Smoking status
1371-1 Read Non-smoker test res17: Smoking status
1372 Read Trivial smoker - < 1 cig/day test res17: Smoking status
1372-1 Read Occasional smoker test res17: Smoking status
1373 Read Light smoker - 1-9 cigs/day test res17: Smoking status
1374 Read Moderate smoker - 10-19 cigs/d test res17: Smoking status
1375 Read Heavy smoker - 20-39 cigs/day test res17: Smoking status
1376 Read Very heavy smoker - 40+cigs/d test res17: Smoking status
1377 Read Ex-trivial smoker (<1/day) test res17: Smoking status
1378 Read Ex-light smoker (1-9/day) test res17: Smoking status
1379 Read Ex-moderate smoker (10-19/day) test res17: Smoking status
137a Read Pipe tobacco consumption test res17: Smoking status
137A Read Ex-heavy smoker (20-39/day) test res17: Smoking status
137b Read Ready to stop smoking test res17: Smoking status
137B Read Ex-very heavy smoker (40+/day) test res17: Smoking status
137c Read Thinking about stopping smoking test res17: Smoking status
137C Read Keeps trying to stop smoking test res17: Smoking status
137d Read Not interested in stopping smoking test res17: Smoking status
137D Read Admitted tobacco cons untrue ? test res17: Smoking status
137e Read Smoking restarted test res17: Smoking status
137E Read Tobacco consumption unknown test res17: Smoking status
137f Read Reason for restarting smoking test res17: Smoking status
137F Read Ex-smoker - amount unknown test res17: Smoking status
137F-99 Read EX-Smoker NOS test res17: Smoking status
137g Read Cigarette pack-years test res17: Smoking status
137G Read Trying to give up smoking test res17: Smoking status
137h Read Minutes from waking to first tobacco consumption test res17: Smoking status
137H Read Pipe smoker test res17: Smoking status
137i Read Ex-tobacco chewer test res17: Smoking status
137I Read Passive smoker test res17: Smoking status
137I0 Read Exposed to tobacco smoke at home test res17: Smoking status
137j Read Ex-cigarette smoker test res17: Smoking status
137J Read Cigar smoker test res17: Smoking status
137k Read Refusal to give smoking status test res17: Smoking status
137K Read Stopped smoking test res17: Smoking status
137K0 Read Recently stopped smoking test res17: Smoking status
137l Read Ex roll-up cigarette smoker test res17: Smoking status
137L Read Current non-smoker test res17: Smoking status
137L-99 Read Tobacco Consumption Nil test res17: Smoking status
137m Read Failed attempt to stop smoking test res17: Smoking status
137M Read Rolls own cigarettes test res17: Smoking status
137n Read Total time smoked test res17: Smoking status
137N Read Ex pipe smoker test res17: Smoking status
137o Read Waterpipe tobacco consumption test res17: Smoking status
137O Read Ex cigar smoker test res17: Smoking status
137P Read Cigarette smoker test res17: Smoking status
137P-1 Read Smoker test res17: Smoking status
137Q Read Smoking started test res17: Smoking status
137Q-1 Read Smoking restarted test res17: Smoking status
137R Read Current smoker test res17: Smoking status
137S Read Ex smoker test res17: Smoking status
137T Read Date ceased smoking test res17: Smoking status
137U Read Not a passive smoker test res17: Smoking status
137V Read Smoking reduced test res17: Smoking status
137W Read Chews tobacco test res17: Smoking status
137X Read Cigarette consumption test res17: Smoking status
137Y Read Cigar consumption test res17: Smoking status
137Z Read Tobacco consumption NOS test res17: Smoking status
13p Read Smoking cessation milestones test res17: Smoking status
13p0 Read Negotiated date for cessation of smoking test res17: Smoking status
13p1 Read Smoking status at 4 weeks test res17: Smoking status
13p2 Read Smoking status between 4 and 52 weeks test res17: Smoking status
13p3 Read Smoking status at 52 weeks test res17: Smoking status
13p4 Read Smoking free weeks test res17: Smoking status
13p7 Read Smoking status at 12 weeks test res17: Smoking status
13WF-1 Read Smoker in the family test res17: Smoking status
9ko Read Current smoker annual review - enhanced services admin test res17: Smoking status
9ko-1 Read Current smoker annual review test res17: Smoking status
ASDFGNO1 Read Non Smoker - Nos test res17: Smoking status
EGTON1024 Read Rolls own cigarettes test res17: Smoking status
EGTON1025 Read Current Smoker NOS test res17: Smoking status
EGTON1026 Read Ex-cigar smoker test res17: Smoking status
EGTON1027 Read Ex- Rolled Tobacco Smoker test res17: Smoking status
EGTON1028 Read Ex-smoker NOS test res17: Smoking status
EGTON320 Read Smoking Status test res17: Smoking status
EGTON321 Read Cigarette smoker test res17: Smoking status
EGTON322 Read Ex-Cigarette Smoker test res17: Smoking status
EGTON324 Read Ex-pipe smoker test res17: Smoking status
EGTON326 Read Current smoker test res17: Smoking status
EGTON327 Read Past smoker test res17: Smoking status
EGTON328 Read Date stopped smoking test res17: Smoking status
EGTONGR11 Read Grade B light smoker (1-10/day) test res17: Smoking status
EGTONGR12 Read Grade C moderate smoker (11-20/day) test res17: Smoking status
EGTONGR13 Read Grade D heavy smoker (>20 Day) test res17: Smoking status
EGTONSM2 Read Smoking Age test res17: Smoking status
EGTONSM3 Read Smoking Age Started test res17: Smoking status
EGTONSM4 Read Smoking Age Ceased test res17: Smoking status
EGTONSM6 Read Smoking clinic test res17: Smoking status
EMISNQEX4 Read Ex-tobacco chewer test res17: Smoking status
EMISNQPR396 Read Primary carer current smoker test res17: Smoking status
EMISNQSM14 Read Smoking increased test res17: Smoking status
EMISNQSN1 Read Snuff use test res17: Smoking status
EMISNQTO12 Read Total time smoked test res17: Smoking status
EMISNQWA11 Read Waterpipe tobacco consumption test res17: Smoking status
EMISOTS1 Read Other smoking information test res17: Smoking status
EMISQCO3 Read Carbon monoxide validation confirms smoker test res17: Smoking status
EMISQDA1 Read Date of last cigarette test res17: Smoking status
EMISQGR1 Read Gradual smoking reduction test res17: Smoking status
EMISSMRE1 Read Smoker (Read codes) test res17: Smoking status
PCSDT1DE9 Read Dependent smoker test res17: Smoking status
PCSDT1HE1 Read Heavy smoker review due test res17: Smoking status

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