The application of lag times in cancer pharmacoepidemiology: a narrative review

Blánaid Hicks*, James A. Kaye, Laurent Azoulay , Kasper Bruun Kristensen , Laurel A. Habel, Anton Pottegård

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)
35 Downloads (Pure)

Abstract

Purpose
With the increasing utilization of medications worldwide, coupled with the increasing availability of long-term data, there is a growing opportunity and need for robust studies evaluating drug–cancer associations. One methodology of importance in such studies is the application of lag times.

Methods
In this narrative review, we discuss the main reasons for using lag times.

Results
Namely, we discuss the typically long latency period of cancer concerning both tumor promoter and initiator effects and outline why cancer latency is a key consideration when choosing a lag time. We also discuss how the use of lag times can help reduce protopathic and detection bias. Finally, we present practical advice for implementing lag periods.

Conclusions
In general, we recommend that researchers consider the information that generated the hypothesis as well as clinical and biological knowledge to inform lag period selection. In addition, given that latency periods are usually unknown, we also advocate that researchers examine multiple lag periods in sensitivity analyses as well as duration analyses and flexible modeling approaches.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalAnnals of Epidemiology
Volume84
Early online date08 Jun 2023
DOIs
Publication statusPublished - Aug 2023

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