Long term use of lithium and risk of colorectal adenocarcinoma: a nationwide case control study
Background:Lithium accumulates in the colon and inhibits the enzyme GSK 3b that possesses anti carcinogenic effects. We therefore examined the association between lithium use and colorectal cancer risk in a nationwide study.Methods:We used the Danish Cancer Registry to identify all patients diagnosed with incident colorectal adenocarcinoma during 2000 2012 (n=36 248) Using a matched case control approach, we estimated the association between long term use (5 years) of lithium and risk of colorectal adenocarcinoma using conditional logistic regression.Results:Long term use of lithium was similar among cases (0.22% and controls (0.20% yielding an odds ratio of 1.13 (95% confidence interval (CI) 0.89 1.43) for colorectal adenocarcinoma. Dose response, subgroup and other subanalyses returned neutral associations. However, ORs differed for colorectal subsites (proximal colon: 1.01 (95% CI, 0.66 1.55; distal colon: 1.52 (95% CI, 1.05 2.20) and rectum: 0.80 (95% CI, 0.50 1.30).Conclusions:Lithium use was not associated with an overall increased risk of colorectal adenocarcinoma. The variation by subsite warrants further investigation.
British Journal of Cancer