据估计，结直肠癌 (CRC) 是加拿大第四大常见癌症诊断（非黑色素瘤皮肤癌除外），并且分别是男性和女性癌症相关死亡的第二和第三大原因。发病的结直肠癌（EAO-CRC；诊断时间小于 50 年）需要更好地了解患者的诊断途径。因此，我们评估了 EAO-CRC 诊断前的处方药使用模式。我们使用加拿大不列颠哥伦比亚省 (BC) 的关联行政健康数据库来识别 2010 年 1 月 1 日至 2016 年 12 月 31 日期间诊断为 EAO-CRC 的个人（以下简称“病例”），以及按年龄和性别匹配的无癌症对照（1:10）。我们确定了诊断前一年内社区药房开出的所有处方，并使用解剖治疗化学分类系统 3 级根据药物类别对处方进行分组。对诊断为平均发病年龄 CRC 的个体（50 岁及以上诊断）进行了平行评估。我们纳入了 1001 例 EAO-CRC 病例（n = 450，45% 女性参与者；平均 41.0，SD 6.1 岁），并且诊断前一年，797 人 (79.7%) 开出了 12,989 份处方。顶部填充的药物是抗抑郁药（第一；n=1698，13.1%）。与对照组相比，EAO-CRC 病例更有可能服用治疗消化性溃疡病和胃食管反流病的药物（第三；n=795，6.1%）（比值比 [OR] 1.4，95% CI 1.2-1.7），并且服用频率更高（OR 1.8，95% CI 1.7-1.9）。我们注意到治疗痔疮和肛裂的外用药物的模式相似，与对照组相比，EAO-CRC 病例更有可能填充这些药物（OR 7.4，95% CI 5.8-9.4），并且填充更频繁（OR 15.6，95% CI 13.1- 18.6).我们观察到在诊断 EAO-CRC 前一年频繁使用处方药，包括治疗常见报告的 EAO-CRC 症状的药物。©Vienna Cheng、Eric C Sayre、Vicki Cheng、Ria Garg、Sharlene Gill、Ameer法鲁克，玛丽·A·德维拉。最初发表于 JMIR Cancer (https://cancer.jmir.org)，2024 年 7 月 12 日。

Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively.The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis.We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as "cases"), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older).We included 1001 EAO-CRC cases (n=450, 45% female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7%) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1%). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1%) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95% CI 1.2-1.7) and with more frequent fills (OR 1.8, 95% CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95% CI 5.8-9.4) and with more frequent fills (OR 15.6, 95% CI 13.1-18.6).We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC.©Vienna Cheng, Eric C Sayre, Vicki Cheng, Ria Garg, Sharlene Gill, Ameer Farooq, Mary A De Vera. Originally published in JMIR Cancer (https://cancer.jmir.org), 12.07.2024.