The effect of warfarin therapy on breast, colorectal, lung, and prostate cancer survival: a population-based cohort study using the Clinical Practice Research Datalink

M A O'Rorke; L J Murray; C M Hughes; M M Cantwell; C R Cardwell

doi:10.1007/s10552-014-0511-2

Back

The effect of warfarin therapy on breast, colorectal, lung, and prostate cancer survival: a population-based cohort study using the Clinical Practice Research Datalink

Journal article

Peer reviewed

The effect of warfarin therapy on breast, colorectal, lung, and prostate cancer survival: a population-based cohort study using the Clinical Practice Research Datalink

M A O'Rorke, L J Murray, C M Hughes, M M Cantwell and C R Cardwell

Cancer causes & control, Vol.26(3), pp.355-366

03/2015

DOI: 10.1007/s10552-014-0511-2

PMID: 25534917

View Online

Abstract

Pre-clinical studies suggest that oral anticoagulant agents, such as warfarin, may inhibit metastases and potentially prolong survival in cancer patients. However, few population-based studies have examined the association between warfarin use and cancer-specific mortality. Using prescribing, cause of death, and cancer registration data from the UK Clinical Practice Research Datalink, four population-based cohorts were constructed, comprising breast, colorectal, lung, and prostate cancer patients diagnosed between 1 January 1998, and the 31 December 2010. Comparing pre-diagnostic warfarin users to non-users, multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for cancer-specific mortality. Overall, 16,525 breast, 12,902 colorectal, 12,296 lung, and 12,772 prostate cancers were included. Pre-diagnostic warfarin use ranged from 2.4 to 4.7 %. There was little evidence of any strong association between warfarin use pre-diagnosis and cancer-specific mortality in prostate (adjusted HR 1.03, 95 % CI 0.84-1.26), lung (adjusted HR 1.06, 95 % CI 0.96-1.16), breast (adjusted HR 0.81, 95 % CI 0.62-1.07), or colorectal (adjusted HR 0.88, 95 % CI 0.77-1.01) cancer patients. Dose-response analyses did not reveal consistent evidence of reductions in users of warfarin defined by the number of prescriptions used and daily defined doses. There was little evidence of associations between pre-diagnostic use of warfarin and cancer-specific mortality in lung, prostate, breast, or colorectal cancer patients.

Colorectal Neoplasms - mortality

Lung Neoplasms - drug therapy

Administration, Oral

Lung Neoplasms - mortality

Humans

Middle Aged

Proportional Hazards Models

Anticoagulants - therapeutic use

Male

Breast Neoplasms - drug therapy

Prostatic Neoplasms - mortality

Incidence

Warfarin - therapeutic use

Neoplasm Metastasis - drug therapy

Colorectal Neoplasms - drug therapy

Aged, 80 and over

Adult

Breast Neoplasms - mortality

Female

Aged

Prostatic Neoplasms - drug therapy

Cohort Studies

Databases, Factual

Details

Title: Subtitle: The effect of warfarin therapy on breast, colorectal, lung, and prostate cancer survival: a population-based cohort study using the Clinical Practice Research Datalink
Creators: M A O'Rorke - Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences Block B, Royal Victoria Hospital Site, Grosvenor Road, Belfast, BT12 6BJ, UK, m.ororke@qub.ac.uk
L J Murray
C M Hughes
M M Cantwell
C R Cardwell
Resource Type: Journal article
Publication Details: Cancer causes & control, Vol.26(3), pp.355-366
Publisher: Netherlands
DOI: 10.1007/s10552-014-0511-2
PMID: 25534917
ISSN: 0957-5243
eISSN: 1573-7225
Grant note: MR/K023241/1 / Medical Research Council
Language: English
Date published: 03/2015
Academic Unit: Epidemiology; Pathology
Record Identifier: 9983996065802771

Metrics

20 Record Views

16 Times Cited - Web of Science

See more details