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Meta-Analysis of the Association Between Phosphodiesterase Inhibitors (PDE5Is) and Risk of Melanoma
NYU, Dept Urol, New York, NY USA.;NYU, New York, NY USA.;Manhattan VA, New York, NY USA..
IRCCS Osped San Raffaele, Div Expt Oncol, Unit Urol, URI, Milan, Italy.;Univ Vita Salute San Raffaele, Milan, Italy.;Umea Univ Hosp, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden..
IRCCS Osped San Raffaele, Div Expt Oncol, Unit Urol, URI, Milan, Italy.;Univ Vita Salute San Raffaele, Milan, Italy..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
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2017 (English)In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 109, no 8, article id djx086Article in journal (Refereed) Published
Abstract [en]

The US Food and Drug Administration recently announced the need to evaluate the association between PDE5is and melanoma. We performed a meta-analysis on the association between PDE5i and melanoma using random effects models and examined whether it met Hill's criteria for causality. A systematic search of Medline, EMBASE, and the Cochrane Library from 1998 to 2016 identified three case-control studies and two cohort studies, including a total of 866 049 men, of whom 41 874 were diagnosed with melanoma. We found a summary estimate indicating an increased risk of melanoma in PDE5i users (relative risk = 1.12, 95% confidence interval = 1.02 to 1.23). However, there was no difference in risk between men with low and high exposure to PDE5i, and risk was higher for in situ melanoma than localized and high-risk melanoma, suggesting a lack of dose response and biological gradient. PDE5i use was also associated with basal cell cancer, suggesting a lack of specificity and likely confounding by ultraviolet exposure. Thus, although this meta-analysis found a statistically significant association between PDE5i and melanoma, it did not satisfy Hill's criteria for causality.

Place, publisher, year, edition, pages
2017. Vol. 109, no 8, article id djx086
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Cancer and Oncology
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URN: urn:nbn:se:uu:diva-333606DOI: 10.1093/jnci/djx086ISI: 000407447000016OAI: oai:DiVA.org:uu-333606DiVA, id: diva2:1158033
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Swedish Cancer Society, 140570Available from: 2017-11-17 Created: 2017-11-17 Last updated: 2017-11-17Bibliographically approved

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