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Tylenol poses a risk of cancer, study indicates

Pittsburgh Post-Gazette

05-11-11

May 11--If you can find some other way of dealing with that annoying headache besides reaching for your favorite over-the-counter painkiller, use it.

That's one lesson people might take from a new study that suggests frequent users of acetaminophen are at slightly higher risk of developing certain blood cancers, said blood specialists John Lister of the West Penn Allegheny Health System and David Claxton of the Penn State Hershey Cancer Institute.

Acetaminophen is sold under the brand name Tylenol.

"I would say if you don't need them or can avoid them [do so]," Dr. Lister, chief of the Division of Hematology and Cellular Therapy at West Penn Allegheny, said of over-the-counter remedies.

The study published online Monday in the Journal of Medical Oncology found that people who chronically used acetaminophen had nearly double the incidence of three types of blood cancers, such as non-Hodgkins lymphomas and plasma cell disorders. However, the risk remained small.

The usual risk for the group studied was "about 1 percent over 10 years for people age 50 and over," said study co-author Emily White of the Fred Hutchinson Cancer Research Center and a professor of epidemiology at the University of Washington in Seattle. The rate was "about 2 percent over 10 years among those who used acetaminophen for at least four years at least four times per week."

The study, which looked at 64,839 men and women ages 50 to 76 who were recruited to an earlier trial called the Vitamins and Lifestyle (VITAL) study, showed no increased risk of blood malignancies for higher use of aspirin, ibuprofen or other nonaspirin, nonsteroidal anti-inflammatory drugs.

Nevertheless, Dr. Lister said he tells his patients, who often are on chemotherapy, that the "lower number of drugs they take the less the chance for an interaction that might harm them."

"This is particularly true for over-the-counter and herbal remedies where we understand so very little about their side effect profiles and the potential to harmfully interact with any other medication."

Despite his warning against using over-the-counter painkillers, he said "when you compare the options for treating pain, acetaminophen would still be considered to be an effective and safe agent."

Dr. Claxton agreed.

"It's not enough to make the [Food and Drug Administration] want to remove the drug from the market. It may not be enough for a physician to counsel patients differently, but this sort of thing will prompt additional studies, and if that confirms this, perhaps it will be reasonable to tell them to do things differently."

He said there have been earlier studies with similar findings, "but this is the best one so far."

Dr. Lister called it "well controlled" and "well constructed ... well conducted study."

Pohla Smith: psmith@post-gazette.com or 412-263-1228.

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