Calcium channel blockers and the incidence of breast and prostate cancer: A meta-analysis

Thakur, Ankita; Wang, X.; Garcia-Betancourt, M. M.; Forse, R. Armour

doi:10.1111/jcpt.12673

Cited by 25 publications

(18 citation statements)

References 73 publications

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“…However, they included studies up to 2012 and did not perform a duration effect analysis. 6,13 One proposed mechanism in which CCBs may induce cancer is the inhibition of apoptosis. 14 CCBs are prescribed for various cardiovascular conditions, including hypertension, angina pectoris, and arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

The Risk for Prostate Cancer With Calcium Channel Blockers: A Systematic Review, Meta-Analysis, and Meta-Regression

2022

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Background For decades, conflicting results were published regarding the increased risk of Prostate cancer (PCa) among calcium channel blocker (CCB) users. Objective We aimed to evaluate the association between PCa and CCB exposure and assess moderating factors. Methods We performed a systematic literature search in PubMed, Embase, and Cochrane databases for observational and randomized studies published until November 2020 with no language limitations, including data on the risk for PCa in CCB users compared with non-CCB users. We applied a random-effects model meta-analysis to pool results. In addition, we investigated potential moderating factors, such as CCB type, study type, participants’ age, and duration of exposure, using meta-regression methods. Results In our primary analysis, we included 18 studies. A statistically significant 5% increase in the risk for PCa was observed among CCB users (risk ratio [RR] = 1.05; 95% confidence interval [CI]: 1.01-1.10), with no significant association between the duration of exposure to CCBs and the risk for PCa (RR = 1.08; 95% CI: 0.98-1.19 for exposure for < 5years and RR = 1.01; 95% CI: 0.9-1.14 for exposure ≥ 5 years). The association remained statistically significant for the subgroup of dihydropyridines (RR = 1.13; 95% CI: 1.05-1.22). In addition, the association was not influenced by participants’ age. Conclusion and Relevance CCBs are an important modality in treating hypertension. The 5% increased risk observed in the current meta-analysis could be influenced by residual confounding factors and should not affect hypertension treatment guidelines until more studies provide additional clinical information.

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Section: Introductionmentioning

confidence: 99%

The Risk for Prostate Cancer With Calcium Channel Blockers: A Systematic Review, Meta-Analysis, and Meta-Regression

2022

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“…In a Spanish population study, CCB consumption increased the odds of breast cancer in postmenopausal women; women with body mass index >25 kg/m 2 (OR, 2.54; 95%CI, 1.24‐5.22); and women with stage III‐IV cancer (OR, 2.70; 95%CI, 1.23‐5.95), nonductal cancer (OR, 2.63; 95%CI, 1.27‐5.43), and ErbB2+ cancer (OR, 2.52; 95%CI, 1.18‐5.37) . A meta‐analysis of 11 relevant studies with high heterogeneity by Thakur et al reported that the OR for the association between breast cancer and CCB use was 1.14 (95%CI, 1.02‐1.27; I 2 , 86.6%), and a 9‐year latency period of CCB use significantly increased the risk of breast cancer. Because tumor formation is a complex consequence of genetic mutations resulting from environmental and lifestyle factors, CCBs may not represent a major contributor to the development of breast tumor.…”

Section: Discussionmentioning

confidence: 99%

Protective Association Between Calcium Channel Blocker Use and Breast Cancer Recurrence in Postsurgical Women: A Population‐Based Case‐Control Study in Taiwan

Shih

Chung

Liao

et al. 2020

The Journal of Clinical Pharma

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Neoadjuvant chemotherapy induces metastasis of residual breast cancers through activation of tumor-associated macrophages. Previous studies have indicated that calcium channel blockers (CCBs) exert anti-inflammatory and antimigratory effects on macrophages via attenuating Ca 2+ entry into macrophages. However, no existing empirical research has addressed the relationship between previous CCB use and breast cancer recurrence. In this study, 4840 Taiwanese women aged ࣙ20 years with breast cancer who underwent breast surgery from January 1, 2007, to December 31, 2015, were enrolled. The date of cancer recurrence was defined as the index date. Logistic regression was performed to evaluate the relationship between previous CCB exposure and cancer recurrence among female patients who underwent surgery for breast cancer. After adjusting for demographic characteristics, comorbidities, and tumor-node-metastasis stage, the adjusted odds ratio (OR) for CCB exposure within 5 years before the index date in women with recurrence compared with nonrecurrent controls was 0.73 (95% confidence interval [CI], 0.53-0.97). Further analysis revealed that the adjusted OR for CCB exposure between the surgery and index dates in women with recurrence relative to nonrecurrent controls was 0.72 (95%CI, 0.66-0.95). In particular, prior CCB use was significantly associated with a lower risk (34%) of breast cancer recurrence among women 20 to 54 years old (OR, 0.66; 95%CI, 0.47-0.83). This study uncovered a protective association between previous CCB use and breast cancer recurrence.

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“…Although there is a lack of robust evidence on the association between CCB use and the majority of cancers, 41 a recent metaanalysis showed that an odds ratio (OR) of 1.14 for the association of breast cancer with CCB use (in particular a 9-year latency period of CCB use), while CCBs may have protective effect on prostate cancer among older populations. 42 A few studies showed that CCBs were associated with a better survival for various cancers, including GC. 23,43,44 However, to our knowledge, this is the first report on the potential chemopreventive effect of CCBs on GC using a well-defined cohort of H pylorieradicated subjects.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of CCBs on cancer development also appear to vary in different organs. Although there is a lack of robust evidence on the association between CCB use and the majority of cancers, 41 a recent meta‐analysis showed that an odds ratio (OR) of 1.14 for the association of breast cancer with CCB use (in particular a 9‐year latency period of CCB use), while CCBs may have protective effect on prostate cancer among older populations 42 …”

Section: Discussionmentioning

confidence: 99%

Calcium channel blockers are associated with lower gastric cancer risk: A territory‐wide study with propensity score analysis

Cheung

Wong

et al. 2020

Intl Journal of Cancer

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Prior studies showed that calcium channel blockers (CCBs) could modify cancer risk, but data on gastric cancer (GC) are limited. We aimed to investigate whether CCBs could modify GC risk in Helicobacter pylori‐eradicated patients. H pylori‐infected patients with hypertension who are aged ≥50 and had received clarithromycin‐based triple therapy between 2003 and 2016 were identified from a territory‐wide healthcare database. Patients with eradication failure, GC diagnosed within 6 months after HP eradication, and gastric ulcer were excluded. Time‐fixed Cox model with one‐to‐one propensity score matching was used to calculate hazard ratio (HR) of GC with CCBs. Sensitivity analysis using time‐dependent multivariable Cox model in which CCB use was treated as time‐varying covariate was also performed to address immortal time bias. 17 622 (29.6%) H pylori‐eradicated patients with hypertension were included. During a median follow‐up of 8.6 years, 105 (0.6%) developed GC. After PS matching, CCBs were associated with a lower GC risk (HR: 0.56; 95% CI: 0.32‐0.97). Time‐dependent analysis showed consistent result (aHR: 0.50; 95% CI: 0.33‐0.75). A longer duration of CCB use was associated with even lower GC risk (adjusted HR [aHR]: 0.69; 95% CI: 0.61‐0.79 for every 1‐year increase in use). Long‐acting CCBs (aHR: 0.47; 95% CI: 0.29‐0.76) and dihydropyridines (aHR: 0.49; 95% CI: 0.32‐0.73) conferred greater benefit than short‐acting ones (aHR: 0.60; 95% CI: 0.36‐1.03) and nondihydropyridines (aHR: 0.76; 95% CI: 0.24‐2.48). The aHR was 0.57 (95% CI: 0.34‐0.97) for noncardia and 0.59 (95% CI: 0.27‐1.31) for cardia cancer. Use of CCBs was associated with lower risk of GC development in H pylori‐eradicated patients, in a duration‐ and dose‐response manner.

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Calcium channel blockers and the incidence of breast and prostate cancer: A meta-analysis

Cited by 25 publications

References 73 publications

The Risk for Prostate Cancer With Calcium Channel Blockers: A Systematic Review, Meta-Analysis, and Meta-Regression

The Risk for Prostate Cancer With Calcium Channel Blockers: A Systematic Review, Meta-Analysis, and Meta-Regression

Protective Association Between Calcium Channel Blocker Use and Breast Cancer Recurrence in Postsurgical Women: A Population‐Based Case‐Control Study in Taiwan

Calcium channel blockers are associated with lower gastric cancer risk: A territory‐wide study with propensity score analysis

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