Association between sedative-hypnotic medication use and incidence of cancer in Korean Nation Health Insurance Service data

Abstract

ObjectivesWe aimed to investigate the association between the use of various sedative-hypnotics and the incidence of overall and individual cancers in a large, population-based, retrospective cohort study. MethodsWe selected a 5% random sample of individuals aged 50 years or older from data maintained by the Korean National Health Insurance Service for the years 2002–2015, excluding individuals with a prior diagnosis of cancer and with any sedative-hypnotic use in the initial two years of follow-up, leaving 236,759 participants for the final analysis. Exposure to sedative-hypnotics was defined by type of drug, standardized to a defined daily dose, and coded as a time-varying variable. Cox proportional hazard models were applied after adjusting for sex, socio-economic status, and comorbidities. ResultsWe observed increased risk for overall cancer among men and women who used sedative-hypnotics (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.01–1.13 for men; HR = 1.21, 95% CI = 1.09–1.25 for women) compared with non-users after full adjustment. In the fully adjusted model, women with any sedative-hypnotic use had significantly increased risk for thyroid (HR = 1.53, 95% CI = 1.24–1.87), breast (HR = 1.29, 95% CI = 1.04–1.61), ovarian (HR = 1.65, 95% CI = 1.10–2.46), and lung cancer (HR = 1.40, 95% CI = 1.17–1.69) compared with non-users. Men with sedative-hypnotic use had increased risk for prostate (HR = 1.36, 95% CI = 1.16–1.58), brain (HR = 1.67, 95% CI = 1.04–2.69), and lung cancer (HR = 1.20, 95% CI = 1.07–1.35) compared with non-users. ConclusionWe found a significant increase in overall cancer incidence among participants who used sedative-hypnotics, and both male and female sedative-hypnotic users had significantly increased risk for certain types of cancer.