β-Blocker usage and colorectal cancer mortality: a nested case-control study in the UK Clinical Practice Research Datalink cohort

B M Hicks, L J Murray, D G Powe, C M Hughes, C R Cardwell

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)

Abstract

BACKGROUND: Epidemiological and laboratory studies suggest that β-blockers may reduce cancer progression in various cancer sites. The aim of this study was to conduct the first epidemiological investigation of the effect of post-diagnostic β-blocker usage on colorectal cancer-specific mortality in a large population-based colorectal cancer patient cohort.

PATIENTS AND METHODS: A nested case-control analysis was conducted within a cohort of 4794 colorectal cancer patients diagnosed between 1998 and 2007. Patients were identified from the UK Clinical Practice Research Datalink and confirmed using cancer registry data. Patients with a colorectal cancer- specific death (data from the Office of National Statistics death registration system) were matched to five controls. Conditional logistic regression was applied to calculate odds ratios (OR) and 95% confidence intervals (95% CIs) according to β-blocker usage (data from GP-prescribing records).

RESULTS: Post-diagnostic β-blocker use was identified in 21.4% of 1559 colorectal cancer-specific deaths and 23.7% of their 7531 matched controls, with little evidence of an association (OR = 0.89 95% CI 0.78-1.02). Similar associations were found when analysing drug frequency, β-blocker type or specific drugs such as propranolol. There was some evidence of a weak reduction in all-cause mortality in β-blocker users (adjusted OR = 0.88; 95% CI 0.77-1.00; P = 0.04) which was in part due to the marked effect of atenolol on cardiovascular mortality (adjusted OR = 0.62; 95% CI 0.40-0.97; P = 0.04).

CONCLUSIONS: In this novel, large UK population-based cohort of colorectal cancer patients, there was no evidence of an association between post-diagnostic β-blocker use and colorectal cancer-specific mortality.

CLINICAL TRIALS NUMBER: NCT00888797.

Original languageEnglish
Pages (from-to)3100-6
Number of pages7
JournalAnnals of oncology : official journal of the European Society for Medical Oncology / ESMO
Volume24
Issue number12
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Adrenergic beta-Antagonists
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents
  • Atenolol
  • Case-Control Studies
  • Colorectal Neoplasms
  • Female
  • Great Britain
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Propranolol
  • Prospective Studies
  • Registries

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