{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:01:01Z","timestamp":1776060061637,"version":"3.50.1"},"reference-count":47,"publisher":"Korean Cancer Association","issue":"2","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100003670","name":"National Evidence-based Healthcare Collaborating Agency","doi-asserted-by":"publisher","award":["NA21-003"],"award-info":[{"award-number":["NA21-003"]}],"id":[{"id":"10.13039\/501100003670","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-crt.org"],"crossmark-restriction":true},"short-container-title":["Cancer Res Treat"],"published-print":{"date-parts":[[2026,4,15]]},"abstract":"<jats:p>PurposeThe aim of this study is to summarize cancer risk among patients with clinical indications of immunosuppressive and antineoplastic drugs in Korea, which are pharmaceuticals defined as group 1 by International Agency for Research on Cancer.Materials and MethodsWe conducted a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service claims data from 2002 to 2018. Patients with clinical indications for group 1 pharmaceuticals from 2002 to 2017 were selected as baseline population, and followed up until 2018. Cox proportional hazards regression model was used to analyze the risk of cancer and dose-response relationship between group 1 pharmaceuticals and cancer.ResultsAzathioprine use increased the risk of skin and hematologic cancer (hazard ratio [HR], 4.63; 95% confidence interval [CI], 2.91 to 7.39 and HR, 3.15; 95% CI, 2.41 to 4.13). Cyclosporine use increased the risk of skin and hematologic cancer (HR, 2.30; 95% CI, 1.79 to 2.95 and HR, 2.96; 95% CI, 2.59 to 3.40). Cyclophosphamide use increased the risk of bladder and hematologic cancer (HR, 2.69; 95% CI, 1.92 to 3.78 and HR, 3.83; 95% CI, 3.20 to 4.59). Chlorambucil use increased the risk of hematologic cancer (HR, 3.51; 95% CI, 2.53 to 4.87) and melphalan use increased the risk of hematologic cancer (HR, 16.31; 95% CI, 13.41 to 19.85). Methoxsalen use increased the risk of skin cancer (HR, 2.32; 95% CI, 1.36 to 3.95).ConclusionGroup 1 pharmaceuticals were associated with increased risk of cancer. The results are expected to help establish alternative clinical strategies and policies for patients with clinical indications of group 1 pharmaceuticals, by continuous risk analysis and discussions on the surveillance systems.<\/jats:p>","DOI":"10.4143\/crt.2024.1201","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T02:57:39Z","timestamp":1745463459000},"page":"376-392","update-policy":"https:\/\/doi.org\/10.4143\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["IARC Group 1 Pharmaceuticals and Associated Cancer Risks: A Nationwide Population-Based Cohort Study in Korea"],"prefix":"10.4143","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8305-0246","authenticated-orcid":true,"given":"Woojin","family":"Lim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na 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