Titre :
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Barbiturates and lung cancer : a re-evaluation. (1999)
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Auteurs :
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G.D. FRIEDMAN ;
L.A. HABEL ;
Division of Research. Kaiser Permanente Medical Care Program. Oakland. CA. USA
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Type de document :
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Article
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Dans :
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International journal of epidemiology (vol. 28, n° 3, 1999)
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Pagination :
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375-379
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Langues:
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Anglais
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Mots-clés :
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Cancer
;
Poumon
;
Barbiturique
;
Epidémiologie
;
Facteur risque
;
Homme
;
Etats Unis
;
Amérique
;
Appareil respiratoire [pathologie]
;
Amérique du Nord
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Résumé :
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[BDSP. Notice produite par INIST eJwR0xoB. Diffusion soumise à autorisation]. Background Barbiturates, particularly phenobarbital, have been shown to be a tumour promoter in animal experiments and were found to be associated with increased risk of lung cancer in our cohort follow-up study to screen pharmaceuticals for possible carcinogenic effects. Sixteen more years of follow-up have accumulated permitting a more detailed evaluation of this association. Methods In all, 10 213 subscribers of the Kaiser Permanente Medical Care Program who received barbiturates between 1969 and 1973 from its San Francisco pharmacy were followed up through 1992 and their incidence of lung cancer at biennial intervals was compared with what was expected based on the experience of the entire pharmacy cohort (143 594). Smoking-habit data were available on about half of the barbiturate users and were used to adjust for cigarette smoking in both the observed/expected analysis and in Cox proportional hazards analysis. Results The initially elevated standard morbidity ratio of 1.55 (95% CI : 1.25-1.91) with 3-7 years of follow-up gradually decreased and stabilized at about 1.3 after 11-15 years of follow-up. This trend for diminishing relative risk over time was more pronounced among the never smokers but their initial excess risk was not statistically significant due to small numbers. A dose-response trend was observed, based on the number of prescriptions dispensed. (...)
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