Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer
Purpose Anticoagulants may reduce mortality of cancer patients, though the evidence remains controversial. We studied the association between different anticoagulants and cancer death. Methods All anticoagulant use during 1995–2015 was analyzed among 75,336 men in the Finnish Randomized Study of Scr...
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| Veröffentlicht in: | Cancer causes & control 2019-08, Vol.30 (8), p.877-888 |
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| creator | Kinnunen, P. T. T. Murtola, T. J. Talala, K. Taari, K. Tammela, T. L. J. Auvinen, A. |
| description | Purpose
Anticoagulants may reduce mortality of cancer patients, though the evidence remains controversial. We studied the association between different anticoagulants and cancer death.
Methods
All anticoagulant use during 1995–2015 was analyzed among 75,336 men in the Finnish Randomized Study of Screening for Prostate Cancer. Men with prevalent cancer were excluded. Multivariable Cox regression was performed to compare risk of death from any cancer and disease-specific death from 9 specific cancer types between (1) anticoagulant users overall and (2) warfarin users compared to anticoagulant non-users and (3) warfarin or (4) low-molecular-weight heparins (LMWH) compared to users of other anticoagulants. Medication use was analyzed as time-dependent variable to minimize immortal time bias. 1-, 2- and 3-year lag-time analyses were performed.
Results
During a median follow-up of 17.2 years, a total of 27,233 men died of whom 8033 with cancer as the primary cause of death. In total, 32,628 men (43%) used anticoagulants. Any anticoagulant use was associated with an increased risk of cancer death (HR = 2.50, 95% CI 2.37–2.64) compared to non-users. Risk was similar independent of the amount, duration, or intensity of use. The risk increase was observed both among warfarin and LMWH users, although not as strong in warfarin users. Additionally, cancer-specific risks of death were similar to overall cancer mortality in all anticoagulant categories.
Conclusion
Our study does not support reduced cancer mortality among anticoagulant users. Future studies on drug use and cancer mortality should be adjusted for anticoagulants as they are associated with significantly higher risk of cancer death. |
| doi_str_mv | 10.1007/s10552-019-01195-x |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2242811679</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48691341</jstor_id><sourcerecordid>48691341</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-939fb772c9c14dcf4486fe708449a46c58cc083490c995a8cd5aca7bc9532ce03</originalsourceid><addsrcrecordid>eNp9kc1LHDEYxoNUdLX9BwotgV68jM3nZHIUqbYgeNFzyL6T2c2yk9gkA65_faOz3UIPHkIO7-953o8Hoc-UXFJC1PdMiZSsIVTXR7Vsno_QgkrFG8WY_IAWREvVSCb4KTrLeUMIkS0jJ-iUU1ZrWi5QfxWKh2hX09aGkrENPQYbwCU8xlTs1pcd9gGXtcM3PgSf1zhVKI7-xfU4l6nf4TjgDMm54MMKDzHhpxRzscXtrT6i48Fus_u0_8_R482Ph-ufzd397a_rq7sGhKCl0VwPS6UYaKCih0GIrh2cIp0Q2ooWZAdAOi40Aa2l7aCXFqxagpacgSP8HF3MvrX_78nlYkafwW3rai5O2TAmWEdpq3RFv_2HbuKUQp3ulaIdbyXrKsVmCupCObnBPCU_2rQzlJjXDMycgakZmLcMzHMVfd1bT8vR9QfJ36NXgM9ArqWwculf73dtv8yqTS4xHVzrjTTlgvI_oE-ckQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2241836528</pqid></control><display><type>article</type><title>Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer</title><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Kinnunen, P. T. T. ; Murtola, T. J. ; Talala, K. ; Taari, K. ; Tammela, T. L. J. ; Auvinen, A.</creator><creatorcontrib>Kinnunen, P. T. T. ; Murtola, T. J. ; Talala, K. ; Taari, K. ; Tammela, T. L. J. ; Auvinen, A.</creatorcontrib><description>Purpose
Anticoagulants may reduce mortality of cancer patients, though the evidence remains controversial. We studied the association between different anticoagulants and cancer death.
Methods
All anticoagulant use during 1995–2015 was analyzed among 75,336 men in the Finnish Randomized Study of Screening for Prostate Cancer. Men with prevalent cancer were excluded. Multivariable Cox regression was performed to compare risk of death from any cancer and disease-specific death from 9 specific cancer types between (1) anticoagulant users overall and (2) warfarin users compared to anticoagulant non-users and (3) warfarin or (4) low-molecular-weight heparins (LMWH) compared to users of other anticoagulants. Medication use was analyzed as time-dependent variable to minimize immortal time bias. 1-, 2- and 3-year lag-time analyses were performed.
Results
During a median follow-up of 17.2 years, a total of 27,233 men died of whom 8033 with cancer as the primary cause of death. In total, 32,628 men (43%) used anticoagulants. Any anticoagulant use was associated with an increased risk of cancer death (HR = 2.50, 95% CI 2.37–2.64) compared to non-users. Risk was similar independent of the amount, duration, or intensity of use. The risk increase was observed both among warfarin and LMWH users, although not as strong in warfarin users. Additionally, cancer-specific risks of death were similar to overall cancer mortality in all anticoagulant categories.
Conclusion
Our study does not support reduced cancer mortality among anticoagulant users. Future studies on drug use and cancer mortality should be adjusted for anticoagulants as they are associated with significantly higher risk of cancer death.</description><identifier>ISSN: 0957-5243</identifier><identifier>EISSN: 1573-7225</identifier><identifier>DOI: 10.1007/s10552-019-01195-x</identifier><identifier>PMID: 31209595</identifier><language>eng</language><publisher>Cham: Springer Science + Business Media</publisher><subject>Aged ; Anticoagulants ; Anticoagulants - therapeutic use ; Biomedical and Life Sciences ; Biomedicine ; Cancer Research ; Death ; Dependent variables ; Early Detection of Cancer ; Epidemiology ; Finland - epidemiology ; Health risk assessment ; Health risks ; Hematology ; Heparin ; Heparin, Low-Molecular-Weight - therapeutic use ; Humans ; Male ; Middle Aged ; Mortality ; Oncology ; ORIGINAL PAPER ; Prostate cancer ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - drug therapy ; Prostatic Neoplasms - mortality ; Public Health ; Randomization ; Risk ; Risk Factors ; Screening ; Time dependence ; Warfarin ; Warfarin - therapeutic use</subject><ispartof>Cancer causes & control, 2019-08, Vol.30 (8), p.877-888</ispartof><rights>The Author(s) 2019</rights><rights>Cancer Causes & Control is a copyright of Springer, (2019). All Rights Reserved. © 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-939fb772c9c14dcf4486fe708449a46c58cc083490c995a8cd5aca7bc9532ce03</citedby><cites>FETCH-LOGICAL-c441t-939fb772c9c14dcf4486fe708449a46c58cc083490c995a8cd5aca7bc9532ce03</cites><orcidid>0000-0003-1432-9272</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48691341$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48691341$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,41464,42533,51294,57992,58225</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31209595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kinnunen, P. T. T.</creatorcontrib><creatorcontrib>Murtola, T. J.</creatorcontrib><creatorcontrib>Talala, K.</creatorcontrib><creatorcontrib>Taari, K.</creatorcontrib><creatorcontrib>Tammela, T. L. J.</creatorcontrib><creatorcontrib>Auvinen, A.</creatorcontrib><title>Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer</title><title>Cancer causes & control</title><addtitle>Cancer Causes Control</addtitle><addtitle>Cancer Causes Control</addtitle><description>Purpose
Anticoagulants may reduce mortality of cancer patients, though the evidence remains controversial. We studied the association between different anticoagulants and cancer death.
Methods
All anticoagulant use during 1995–2015 was analyzed among 75,336 men in the Finnish Randomized Study of Screening for Prostate Cancer. Men with prevalent cancer were excluded. Multivariable Cox regression was performed to compare risk of death from any cancer and disease-specific death from 9 specific cancer types between (1) anticoagulant users overall and (2) warfarin users compared to anticoagulant non-users and (3) warfarin or (4) low-molecular-weight heparins (LMWH) compared to users of other anticoagulants. Medication use was analyzed as time-dependent variable to minimize immortal time bias. 1-, 2- and 3-year lag-time analyses were performed.
Results
During a median follow-up of 17.2 years, a total of 27,233 men died of whom 8033 with cancer as the primary cause of death. In total, 32,628 men (43%) used anticoagulants. Any anticoagulant use was associated with an increased risk of cancer death (HR = 2.50, 95% CI 2.37–2.64) compared to non-users. Risk was similar independent of the amount, duration, or intensity of use. The risk increase was observed both among warfarin and LMWH users, although not as strong in warfarin users. Additionally, cancer-specific risks of death were similar to overall cancer mortality in all anticoagulant categories.
Conclusion
Our study does not support reduced cancer mortality among anticoagulant users. Future studies on drug use and cancer mortality should be adjusted for anticoagulants as they are associated with significantly higher risk of cancer death.</description><subject>Aged</subject><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cancer Research</subject><subject>Death</subject><subject>Dependent variables</subject><subject>Early Detection of Cancer</subject><subject>Epidemiology</subject><subject>Finland - epidemiology</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Hematology</subject><subject>Heparin</subject><subject>Heparin, Low-Molecular-Weight - therapeutic use</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Oncology</subject><subject>ORIGINAL PAPER</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Public Health</subject><subject>Randomization</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Screening</subject><subject>Time dependence</subject><subject>Warfarin</subject><subject>Warfarin - therapeutic use</subject><issn>0957-5243</issn><issn>1573-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1LHDEYxoNUdLX9BwotgV68jM3nZHIUqbYgeNFzyL6T2c2yk9gkA65_faOz3UIPHkIO7-953o8Hoc-UXFJC1PdMiZSsIVTXR7Vsno_QgkrFG8WY_IAWREvVSCb4KTrLeUMIkS0jJ-iUU1ZrWi5QfxWKh2hX09aGkrENPQYbwCU8xlTs1pcd9gGXtcM3PgSf1zhVKI7-xfU4l6nf4TjgDMm54MMKDzHhpxRzscXtrT6i48Fus_u0_8_R482Ph-ufzd397a_rq7sGhKCl0VwPS6UYaKCih0GIrh2cIp0Q2ooWZAdAOi40Aa2l7aCXFqxagpacgSP8HF3MvrX_78nlYkafwW3rai5O2TAmWEdpq3RFv_2HbuKUQp3ulaIdbyXrKsVmCupCObnBPCU_2rQzlJjXDMycgakZmLcMzHMVfd1bT8vR9QfJ36NXgM9ArqWwculf73dtv8yqTS4xHVzrjTTlgvI_oE-ckQ</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Kinnunen, P. T. T.</creator><creator>Murtola, T. J.</creator><creator>Talala, K.</creator><creator>Taari, K.</creator><creator>Tammela, T. L. J.</creator><creator>Auvinen, A.</creator><general>Springer Science + Business Media</general><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1432-9272</orcidid></search><sort><creationdate>20190801</creationdate><title>Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer</title><author>Kinnunen, P. 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J. ; Auvinen, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-939fb772c9c14dcf4486fe708449a46c58cc083490c995a8cd5aca7bc9532ce03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Anticoagulants</topic><topic>Anticoagulants - therapeutic use</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cancer Research</topic><topic>Death</topic><topic>Dependent variables</topic><topic>Early Detection of Cancer</topic><topic>Epidemiology</topic><topic>Finland - epidemiology</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Hematology</topic><topic>Heparin</topic><topic>Heparin, Low-Molecular-Weight - therapeutic use</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Oncology</topic><topic>ORIGINAL PAPER</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - drug therapy</topic><topic>Prostatic Neoplasms - mortality</topic><topic>Public Health</topic><topic>Randomization</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Screening</topic><topic>Time dependence</topic><topic>Warfarin</topic><topic>Warfarin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kinnunen, P. T. T.</creatorcontrib><creatorcontrib>Murtola, T. J.</creatorcontrib><creatorcontrib>Talala, K.</creatorcontrib><creatorcontrib>Taari, K.</creatorcontrib><creatorcontrib>Tammela, T. L. J.</creatorcontrib><creatorcontrib>Auvinen, A.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer causes & control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kinnunen, P. T. T.</au><au>Murtola, T. J.</au><au>Talala, K.</au><au>Taari, K.</au><au>Tammela, T. L. J.</au><au>Auvinen, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer</atitle><jtitle>Cancer causes & control</jtitle><stitle>Cancer Causes Control</stitle><addtitle>Cancer Causes Control</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>30</volume><issue>8</issue><spage>877</spage><epage>888</epage><pages>877-888</pages><issn>0957-5243</issn><eissn>1573-7225</eissn><abstract>Purpose
Anticoagulants may reduce mortality of cancer patients, though the evidence remains controversial. We studied the association between different anticoagulants and cancer death.
Methods
All anticoagulant use during 1995–2015 was analyzed among 75,336 men in the Finnish Randomized Study of Screening for Prostate Cancer. Men with prevalent cancer were excluded. Multivariable Cox regression was performed to compare risk of death from any cancer and disease-specific death from 9 specific cancer types between (1) anticoagulant users overall and (2) warfarin users compared to anticoagulant non-users and (3) warfarin or (4) low-molecular-weight heparins (LMWH) compared to users of other anticoagulants. Medication use was analyzed as time-dependent variable to minimize immortal time bias. 1-, 2- and 3-year lag-time analyses were performed.
Results
During a median follow-up of 17.2 years, a total of 27,233 men died of whom 8033 with cancer as the primary cause of death. In total, 32,628 men (43%) used anticoagulants. Any anticoagulant use was associated with an increased risk of cancer death (HR = 2.50, 95% CI 2.37–2.64) compared to non-users. Risk was similar independent of the amount, duration, or intensity of use. The risk increase was observed both among warfarin and LMWH users, although not as strong in warfarin users. Additionally, cancer-specific risks of death were similar to overall cancer mortality in all anticoagulant categories.
Conclusion
Our study does not support reduced cancer mortality among anticoagulant users. Future studies on drug use and cancer mortality should be adjusted for anticoagulants as they are associated with significantly higher risk of cancer death.</abstract><cop>Cham</cop><pub>Springer Science + Business Media</pub><pmid>31209595</pmid><doi>10.1007/s10552-019-01195-x</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-1432-9272</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anticoagulants Anticoagulants - therapeutic use Biomedical and Life Sciences Biomedicine Cancer Research Death Dependent variables Early Detection of Cancer Epidemiology Finland - epidemiology Health risk assessment Health risks Hematology Heparin Heparin, Low-Molecular-Weight - therapeutic use Humans Male Middle Aged Mortality Oncology ORIGINAL PAPER Prostate cancer Prostatic Neoplasms - diagnosis Prostatic Neoplasms - drug therapy Prostatic Neoplasms - mortality Public Health Randomization Risk Risk Factors Screening Time dependence Warfarin Warfarin - therapeutic use |
| title | Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer |
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