world cancer report - iarc
world cancer report - iarc
world cancer report - iarc
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solution, containing a 1% solution of<br />
potassium arsenite in aqueous alcohol).<br />
The no-longer used radioactive X-ray<br />
contrast medium Thorotrast was associated<br />
with increased risk of angiosarcoma.<br />
Certain others have been found to<br />
be carcinogenic in experimental animals<br />
but have not been linked to <strong>cancer</strong>s in<br />
humans despite extensive study. Some<br />
of these drugs have been withdrawn<br />
from clinical use (e.g. phenolphthalein),<br />
while others continue to be used<br />
because the benefit to individual<br />
patients is great and the risk of <strong>cancer</strong> is<br />
considered very slight (e.g. iron dextran,<br />
injectable; phenobarbital; phenytoin).<br />
Some drugs that have been recently<br />
introduced into human medicine, including<br />
the antiretroviral drugs zidovudine<br />
(AZT) and zalcitabine (ddC), are carcinogenic<br />
in experimental animals and may<br />
possibly be carcinogenic to humans<br />
(IARC Group 2B), although there is as yet<br />
no direct evidence of increased <strong>cancer</strong><br />
risk in treated patients [6].<br />
Surgical implants of various kinds are<br />
widely used for both therapeutic and<br />
cosmetic purposes [7]. Foreign bodies of<br />
many kinds cause development of malignant<br />
tumours of connective tissue (sarcomas)<br />
when implanted in tissues or<br />
body cavities of experimental rodents<br />
and left in place for long periods.<br />
Foreign bodies include both metallic and<br />
non-metallic solid objects, and nonabsorbable<br />
or very slowly absorbable<br />
liquid suspensions. Sarcomas develop in<br />
rodents immediately adjacent to the foreign<br />
body, in the soft connective tissues<br />
or in bone and/or cartilage. There have<br />
been more than 60 published case<br />
<strong>report</strong>s of sarcomas and other kinds of<br />
<strong>cancer</strong>s that have developed in humans<br />
at the sites of surgical implants or other<br />
foreign bodies. However, there are no<br />
controlled studies that would allow a<br />
conclusion that these <strong>cancer</strong>s were<br />
indeed caused by the pre-existing foreign<br />
body. Female breast implants have<br />
been extensively studied, and for silicone<br />
implants there is evidence suggesting<br />
lack of carcinogenicity for breast carcinoma<br />
in women who have received<br />
these implants.<br />
Drug or drug combination Cancer site/<strong>cancer</strong><br />
IARC Group 1<br />
Analgesic mixtures containing phenacetin Kidney, bladder<br />
Azathioprine Lymphoma, skin, liver<br />
and bile ducts, soft<br />
connective tissues<br />
N,N-bis(2-chloroethyl)-2-naphthylamine (Chlornaphazine) Bladder<br />
1,4-Butanediol dimethane-sulfonate (Myleran; Busulfan) Leukaemia<br />
Chlorambucil Leukaemia<br />
1-(2-Chloroethyl)-3-(4-methyl-cyclohexyl)-1-nitrosourea Leukaemia<br />
(Methyl-CCNU)<br />
Ciclosporin Lymphoma,<br />
Kaposi sarcoma<br />
Cyclophosphamide Leukaemia, bladder<br />
Diethylstilbestrol Cervix, vagina<br />
Etoposide in combination with cisplatin and bleomycin Leukaemia<br />
Fowler's solution (inorganic arsenic) Skin<br />
Melphalan Leukaemia<br />
8-Methoxypsoralen (Methoxsalen) plus ultraviolet radiation Skin<br />
MOPP and other combined [anti<strong>cancer</strong>] chemotherapy Leukaemia<br />
including alkylating agents<br />
Estrogen therapy, postmenopausal Breast, uterus<br />
Estrogens, non-steroidal Cervix/vagina<br />
Estrogens, steroidal Uterus, breast<br />
Oral contraceptives, combined a Liver<br />
Oral contraceptives, sequential Uterus<br />
Tamoxifen b Uterus<br />
Thiotepa Leukaemia<br />
Treosulfan Leukaemia<br />
a There is also conclusive evidence that these agents have a protective effect against <strong>cancer</strong>s of the ovary<br />
and endometrium.<br />
b There is conclusive evidence that tamoxifen has a protective effect against second breast tumours in<br />
patients with breast <strong>cancer</strong>.<br />
Table 2.13 Medicinal drugs that are classified as being carcinogenic to humans (IARC Group 1).<br />
Medicinal drugs 49