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Research article:
Sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the CPRD primary care database
Reference:
Caroline Fairhurst, Fabiola Martin, Ian Watt, Tim Doran, Martin Bland, William J. Brackenbury(2016) Sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the CPRD primary care database. BMJ Open, doi:
- Link to fulltext article
- Abstract
- Introduction: Voltage-gated sodium channel (VGSC)-inhibiting drugs are commonly used to treat epilepsy and cardiac arrhythmia. VGSCs are also widely expressed in various cancers, including those of the breast, bowel and prostate. A number of VGSC-inhibiting drugs have been shown to inhibit cancer cell proliferation, invasion, tumour growth and metastasis in preclinical models, suggesting that VGSCs may be novel molecular targets for cancer treatment. Surprisingly, we previously found that prior exposure to VGSC-inhibiting drugs may be associated with reduced overall survival in cancer patients, but we were unable to control for cause of death or indication for prescription. The purpose of the present study is to interrogate a different database in order to further investigate the relationship between VGSC-inhibiting drugs and cancer-specific survival. Methods and analysis: A cohort study using primary care data from the Clinical Practice Research Datalink (CPRD) database will include patients with diagnosis of breast, bowel and prostate cancer (approx. n=13,000). The primary outcome will be cancer-specific survival from date of cancer diagnosis. Cox proportional hazards regression will be used to compare survival of patients taking VGSC-inhibiting drugs (including antiepileptic drugs and Class I antiarrhythmic agents) with cancer patients not taking these drugs, adjusting for cancer type, age and sex. Drug exposure will be treated as a time-varying covariate to account for potential immortal time bias. Various sensitivity and secondary analyses will be performed. Ethics and dissemination: The project has been reviewed and approved by the University of York Ethical Review Process. Results will be presented at an international conference and published in open access peer-reviewed journals according to the STROBE and RECORD guidelines.
- Author for correspondence
- William J. Brackenbury
- Email for correspondence
- william.brackenbury@york.ac.uk
Code list: res47: Cancer
97 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 1427000 | Read | H/O: prostate cancer | diagnostic | res47: Cancer | |||
| 1J08.00 | Read | Suspected prostate cancer | diagnostic | res47: Cancer | |||
| 4M0..00 | Read | Gleason grading of prostate cancer | diagnostic | res47: Cancer | |||
| 4M00.00 | Read | Gleason prostate grade 2-4 (low) | diagnostic | res47: Cancer | |||
| 4M01.00 | Read | Gleason prostate grade 5-7 (medium) | diagnostic | res47: Cancer | |||
| 4M02.00 | Read | Gleason prostate grade 8-10 (high) | diagnostic | res47: Cancer | |||
| B13..00 | Read | Malignant neoplasm of colon | diagnostic | res47: Cancer | |||
| B130.00 | Read | Malignant neoplasm of hepatic flexure of colon | diagnostic | res47: Cancer | |||
| B131.00 | Read | Malignant neoplasm of transverse colon | diagnostic | res47: Cancer | |||
| B132.00 | Read | Malignant neoplasm of descending colon | diagnostic | res47: Cancer | |||
| B133.00 | Read | Malignant neoplasm of sigmoid colon | diagnostic | res47: Cancer | |||
| B134.00 | Read | Malignant neoplasm of caecum | diagnostic | res47: Cancer | |||
| B134.11 | Read | Carcinoma of caecum | diagnostic | res47: Cancer | |||
| B135.00 | Read | Malignant neoplasm of appendix | diagnostic | res47: Cancer | |||
| B136.00 | Read | Malignant neoplasm of ascending colon | diagnostic | res47: Cancer | |||
| B137.00 | Read | Malignant neoplasm of splenic flexure of colon | diagnostic | res47: Cancer | |||
| B138.00 | Read | Malignant neoplasm, overlapping lesion of colon | diagnostic | res47: Cancer | |||
| B139.00 | Read | Hereditary nonpolyposis colon cancer | diagnostic | res47: Cancer | |||
| B13y.00 | Read | Malignant neoplasm of other specified sites of colon | diagnostic | res47: Cancer | |||
| B13z.00 | Read | Malignant neoplasm of colon NOS | diagnostic | res47: Cancer | |||
| B13z.11 | Read | Colonic cancer | diagnostic | res47: Cancer | |||
| B14..00 | Read | Malignant neoplasm of rectum, rectosigmoid junction and anus | diagnostic | res47: Cancer | |||
| B140.00 | Read | Malignant neoplasm of rectosigmoid junction | diagnostic | res47: Cancer | |||
| B141.00 | Read | Malignant neoplasm of rectum | diagnostic | res47: Cancer | |||
| B141.11 | Read | Carcinoma of rectum | diagnostic | res47: Cancer | |||
| B141.12 | Read | Rectal carcinoma | diagnostic | res47: Cancer | |||
| B142.00 | Read | Malignant neoplasm of anal canal | diagnostic | res47: Cancer | |||
| B142000 | Read | Malignant neoplasm of cloacogenic zone | diagnostic | res47: Cancer | |||
| B142.11 | Read | Anal carcinoma | diagnostic | res47: Cancer | |||
| B143.00 | Read | Malignant neoplasm of anus unspecified | diagnostic | res47: Cancer | |||
| B14y.00 | Read | Malig neop other site rectum, rectosigmoid junction and anus | diagnostic | res47: Cancer | |||
| B14z.00 | Read | Malignant neoplasm rectum,rectosigmoid junction and anus NOS | diagnostic | res47: Cancer | |||
| B1z0.11 | Read | Cancer of bowel | diagnostic | res47: Cancer | |||
| B34..00 | Read | Malignant neoplasm of female breast | diagnostic | res47: Cancer | |||
| B340.00 | Read | Malignant neoplasm of nipple and areola of female breast | diagnostic | res47: Cancer | |||
| B340000 | Read | Malignant neoplasm of nipple of female breast | diagnostic | res47: Cancer | |||
| B340100 | Read | Malignant neoplasm of areola of female breast | diagnostic | res47: Cancer | |||
| B340z00 | Read | Malignant neoplasm of nipple or areola of female breast NOS | diagnostic | res47: Cancer | |||
| B341.00 | Read | Malignant neoplasm of central part of female breast | diagnostic | res47: Cancer | |||
| B34..11 | Read | Ca female breast | diagnostic | res47: Cancer | |||
| B342.00 | Read | Malignant neoplasm of upper-inner quadrant of female breast | diagnostic | res47: Cancer | |||
| B343.00 | Read | Malignant neoplasm of lower-inner quadrant of female breast | diagnostic | res47: Cancer | |||
| B344.00 | Read | Malignant neoplasm of upper-outer quadrant of female breast | diagnostic | res47: Cancer | |||
| B345.00 | Read | Malignant neoplasm of lower-outer quadrant of female breast | diagnostic | res47: Cancer | |||
| B346.00 | Read | Malignant neoplasm of axillary tail of female breast | diagnostic | res47: Cancer | |||
| B347.00 | Read | Malignant neoplasm, overlapping lesion of breast | diagnostic | res47: Cancer | |||
| B34y.00 | Read | Malignant neoplasm of other site of female breast | diagnostic | res47: Cancer | |||
| B34y000 | Read | Malignant neoplasm of ectopic site of female breast | diagnostic | res47: Cancer | |||
| B34yz00 | Read | Malignant neoplasm of other site of female breast NOS | diagnostic | res47: Cancer | |||
| B34z.00 | Read | Malignant neoplasm of female breast NOS | diagnostic | res47: Cancer | |||
| B35..00 | Read | Malignant neoplasm of male breast | diagnostic | res47: Cancer | |||
| B350.00 | Read | Malignant neoplasm of nipple and areola of male breast | diagnostic | res47: Cancer | |||
| B350000 | Read | Malignant neoplasm of nipple of male breast | diagnostic | res47: Cancer | |||
| B350100 | Read | Malignant neoplasm of areola of male breast | diagnostic | res47: Cancer | |||
| B35z.00 | Read | Malignant neoplasm of other site of male breast | diagnostic | res47: Cancer | |||
| B35z000 | Read | Malignant neoplasm of ectopic site of male breast | diagnostic | res47: Cancer | |||
| B35zz00 | Read | Malignant neoplasm of male breast NOS | diagnostic | res47: Cancer | |||
| B36..00 | Read | Local recurrence of malignant tumour of breast | diagnostic | res47: Cancer | |||
| B46..00 | Read | Malignant neoplasm of prostate | diagnostic | res47: Cancer | |||
| B575.00 | Read | Secondary malignant neoplasm of large intestine and rectum | diagnostic | res47: Cancer | |||
| B575000 | Read | Secondary malignant neoplasm of colon | diagnostic | res47: Cancer | |||
| B575100 | Read | Secondary malignant neoplasm of rectum | diagnostic | res47: Cancer | |||
| B575z00 | Read | Secondary malig neop of large intestine or rectum NOS | diagnostic | res47: Cancer | |||
| B58y000 | Read | Secondary malignant neoplasm of breast | diagnostic | res47: Cancer | |||
| B58y500 | Read | Secondary malignant neoplasm of prostate | diagnostic | res47: Cancer | |||
| B7C2000 | Read | Adenoma of prostate | diagnostic | res47: Cancer | |||
| B803.00 | Read | Carcinoma in situ of colon | diagnostic | res47: Cancer | |||
| B803000 | Read | Carcinoma in situ of hepatic flexure of colon | diagnostic | res47: Cancer | |||
| B803100 | Read | Carcinoma in situ of transverse colon | diagnostic | res47: Cancer | |||
| B803200 | Read | Carcinoma in situ of descending colon | diagnostic | res47: Cancer | |||
| B803300 | Read | Carcinoma in situ of sigmoid colon | diagnostic | res47: Cancer | |||
| B803400 | Read | Carcinoma in situ of caecum | diagnostic | res47: Cancer | |||
| B803500 | Read | Carcinoma in situ of appendix | diagnostic | res47: Cancer | |||
| B803600 | Read | Carcinoma in situ of ascending colon | diagnostic | res47: Cancer | |||
| B803700 | Read | Carcinoma in situ of splenic flexure of colon | diagnostic | res47: Cancer | |||
| B803800 | Read | High grade dysplasia of colon | diagnostic | res47: Cancer | |||
| B803z00 | Read | Carcinoma in situ of colon NOS | diagnostic | res47: Cancer | |||
| B804.00 | Read | Carcinoma in situ of rectum and rectosigmoid junction | diagnostic | res47: Cancer | |||
| B804000 | Read | Carcinoma in situ of rectosigmoid junction | diagnostic | res47: Cancer | |||
| B804100 | Read | Carcinoma in situ of rectum | diagnostic | res47: Cancer | |||
| B804z00 | Read | Carcinoma in situ of rectum or rectosigmoid junction NOS | diagnostic | res47: Cancer | |||
| B830.00 | Read | Carcinoma in situ of breast | diagnostic | res47: Cancer | |||
| B830000 | Read | Lobular carcinoma in situ of breast | diagnostic | res47: Cancer | |||
| B830100 | Read | Intraductal carcinoma in situ of breast | diagnostic | res47: Cancer | |||
| B834.00 | Read | Carcinoma in situ of prostate | diagnostic | res47: Cancer | |||
| B834000 | Read | High grade prostatic intraepithelial neoplasia | diagnostic | res47: Cancer | |||
| B834100 | Read | Prostatic intraepithelial neoplasia | diagnostic | res47: Cancer | |||
| B902000 | Read | Neoplasm of uncertain behaviour of stomach | diagnostic | res47: Cancer | |||
| B902400 | Read | Neoplasm of uncertain behaviour of colon | diagnostic | res47: Cancer | |||
| B902500 | Read | Neoplasm of uncertain behaviour of rectum | diagnostic | res47: Cancer | |||
| B902z00 | Read | Neop of uncertain behaviour stomach, intestine or rectum NOS | diagnostic | res47: Cancer | |||
| B915.00 | Read | Neoplasm of uncertain behaviour of prostate | diagnostic | res47: Cancer | |||
| B933.00 | Read | Neoplasm of uncertain behaviour of breast | diagnostic | res47: Cancer | |||
| BA03.00 | Read | Neoplasm of unspecified nature of breast | diagnostic | res47: Cancer | |||
| BB94.11 | Read | [M]Secretory breast carcinoma | diagnostic | res47: Cancer | |||
| Byu6.00 | Read | [X]Malignant neoplasm of breast | diagnostic | res47: Cancer | |||
| ZV10415 | Read | [V]Personal history of malignant neoplasm of prostate | diagnostic | res47: Cancer |
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