{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:19:59Z","timestamp":1783642799681,"version":"3.55.0"},"reference-count":28,"publisher":"Korean Association of Internal Medicine","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Korean Association of Internal Medicine","award":["2022-01"],"award-info":[{"award-number":["2022-01"]}]}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:p>Background\/Aims: Concerns exist regarding the potential carcinogenic effect of N-nitrosodimethylamine (NDMA) as a contaminant of the antihypertensive medication, valsartan. This study evaluated the association of NDMA-contaminated valsartan with cancer incidence.Methods: Nationwide longitudinal observational cohort of 3,231,212 participants from the National Health Insurance Service of South Korea consisted and was followed up more than 7 years. We performed 1:1:1 pairwise propensity score matching (PSM) of NDMA-uncontaminated, NDMA-contaminated, and initially-suspended-but-finally confirmed as NDMA-uncontaminated valsartan user-groups. The primary outcome was any primary cancer incidence. The secondary outcome was the incidences of 12 organ-specific cancers. The risks of all-cause and cardiovascular deaths were estimated before and after the withdrawal of valsartan.Results: Among participants (59.5 \u00b1 13.1 yr; male, 53.5%), valsartan new users had adjusted hazard ratios and 95% confidence intervals of 1.069 (1.054\u20131.085) and 1.172 (1.128\u20131.216) for any cancer in the NDMA-exposed period (versus NDMA-unexposed) before and after PSM, respectively. Regardless of PSM, prostate cancer risk increased significantly. All-cause and cardiovascular mortality did not differ significantly with NDMA exposure before and after emergent banning.Conclusions: Use of valsartan products contaminated with NDMA was associated with a modestly increased risk of overall cancer compared with uncontaminated products, a finding that requires confirmation in further studies.<\/jats:p>","DOI":"10.3904\/kjim.2026.023","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:47:12Z","timestamp":1782956832000},"page":"676-689","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The medical impact of emergent banning of N-nitrosodimethylamine: contaminated antihypertensive drug"],"prefix":"10.3904","volume":"41","author":[{"given":"Juhee","family":"Ahn","sequence":"first","affiliation":[{"name":"Division of Data Science, College of Intelligent Software Convergence, University of Suwon, Suwon, Korea"},{"name":"Department of Public Health Sciences, Seoul National University, Seoul, Korea"},{"name":"Institute of Health and Environment, Seoul National University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungho","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Seoul National University, Seoul, Korea"},{"name":"Institute of Health and Environment, Seoul National University, Seoul, Korea"},{"name":"RexSoft Inc., Seoul, Korea"},{"name":"Interdisciplinary Program for Bioinformatics, College of Natural Sciences, Seoul National University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Heon","family":"Park","sequence":"additional","affiliation":[{"name":"National Health Insurance Service, Wonju, Korea"},{"name":"Department of Benefits Strategy, National Health Insurance Service, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9521-4102","authenticated-orcid":true,"given":"Hae-Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea"},{"name":"Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","first-page":"558","type":"journal-article","volume-title":"Antihypertensive treatment and risk of cancer: an individual participant data 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