Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.679267
Title: Pharmacological exposures, cancer treatments and disease progression among cancer patients
Author: McMenamin, Úna
ISNI:       0000 0004 5371 5528
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2014
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Abstract:
The evidence base for the effect of common pharmacological exposures among patients diagnosed with cancer is sparse. Routinely collected health data however, can facilitate the conduct of pharmacoepidemiological research into cancer care and outcomes. This PhD study comprised (i) a systematic review of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) use and cancer progression and survival; (ii) a systematic review and meta-analysis of non-steroidal anti-inflammatory drug (NSAID) use and colorectal cancer outcomes; (iii) a nested-case control study of ACEI and ARB use and risk of breast cancer mortality; (iv) a nested-case control study of ACEI and ARB use and risk of prostate cancer mortality and; (v) an overview of cancer treatments received among women, recently diagnosed with breast cancer in Northern Ireland. Individual studies identified within the first systematic review showed inconsistencies with respect to the association between ACEls/ARBs and cancer outcomes and following on from this, findings from two large population-based studies indicated little evidence of a beneficial association between ACEI or ARB use and breast and prostate cancer mortality outcomes, respectively, although a possible protective association was noted for ACEls and risk of prostate cancer mortality. Similarly, there was limited evidence to suggest an association between NSAID use and clinical outcomes from colorectal cancer, based on findings from the second systematic review and meta-analysis. Using data sources from within the Northern Ireland Cancer Registry, a retrospective population-based dataset of breast cancer patients, recently diagnosed in Northern Ireland was constructed. Cancer treatments were deemed appropriate and particular attention was given to adjuvant systemic therapies (including chemotherapy and hormone therapy). This dataset will enable future data linkage with dispensed medication records. Considering the frequency with which ACEls, ARBs, as well as NSAIDs are prescribed, further research into cancer outcomes with respect to these agents is warranted.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.679267  DOI: Not available
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