scholarly journals Post-Diagnostic Beta Blocker Use and Breast Cancer-Specific Mortality: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Oliver William Scott ◽  
Sandar TinTin ◽  
J Mark Elwood ◽  
Alana Cavadino ◽  
Laurel A Habel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Beta Blockers ◽  
Cancer Registries ◽  
Population Based ◽  
Hospital Discharges ◽  
Cox Proportional Hazard ◽  
Breast Cancer Outcomes ◽  
Increased Risk ◽  
Cox Proportional Hazard Models ◽  
Cancer Specific Mortality

Abstract Purpose Beta blockers (BB) have been associated with improved, worsened, or unchanged breast cancer outcomes in previous studies. This study examines the association between the post-diagnostic use of BBs and death from breast cancer in a large, representative sample of New Zealand (NZ) women with breast cancer. Methods Women diagnosed with a first primary breast cancer between 2007 and 2016 were identified from four population-based regional NZ breast cancer registries and linked to national pharmaceutical data, hospital discharges, and death records. The median follow up time was 4.51 years. Cox proportional hazard models were used to estimate the hazard of breast cancer-specific death (BCD) associated with post-diagnostic BB use. Results Of the 14,976 women included in analyses, 21% used a BB after diagnosis. BB use (vs non-use) was associated with a small and non-statistically significant increased risk of BCD ( adjusted hazard ratio: 1.11; 95% CI: 0.95-1.29). A statistically significant increased risk confined to short-term use (0-3 months) was seen (HR=1.40; 1.14-1.73), and this risk steadily decreased with increasing duration of use and became a statistically significant protective effect at 3+ years of use (HR=0.54; 0.34-0.87). Conclusion Our findings suggest that any increased risk associated with BB use may be driven by risk in the initial few months of use. Long-term BB use may be associated with a reduction in BCD.

scholarly journals 523Use of beta blockers and death from breast cancer in New Zealand breast cancer patients

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Oliver Scott ◽  
Sandar TinTin ◽  
Alana Cavadino ◽  
Mark Elwood
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Beta Blockers ◽  
Cancer Registries ◽  
Population Based ◽  
Breast Cancer Patients ◽  
Short Term ◽  
Breast Cancer Death ◽  
Increased Risk

Abstract Background Beta blockers (BB), used for a range of cardiovascular indications, have been associated with improved, worsened, and unchanged breast cancer outcomes in previous studies. This study examines the association between the use of BBs and death from breast cancer in a large, representative sample of New Zealand women. Methods Women diagnosed with a first primary breast cancer between 2007 and 2016 were identified from four population-based regional NZ breast cancer registries and linked to pharmaceutical data, hospital discharges, and death records. The median follow up time was 4.51 years. Cox proportional hazard models were used to assess the hazard of breast cancer specific death (BCD) associated with post-diagnostic BB use. Results Of the 14,976 women included in analysis, 21% used a BB after diagnosis. Although not significant, beta blocker use increased the risk of BCD (adjusted hazard ratio: 1.08; 95% CI: 0.93-1.26). The increased risk was seen only in those with at least one cardiac condition, and was also reduced by lagging the exposure, suggesting effects of BB use close to the end of life. The increased risk was also confined to short term use (0-3 months). BB use for more than 1 year was associated with a decreased risk of BCD, and the risk steadily decreased to HR 0.53 (95% CI: 0.33-0.85) for use for 3+ years. Conclusions Any increased risk associated with BB use is likely to be due to a combination of confounding by indication and short-term use. Long-term BB use may confer some protection for BCD. Key messages The effect of beta blockers is difficult to separate from the indications for the drug. While there was no significant overall effect, there was a suggestion that beta blockers may be protective for breast cancer death with long-term exposure.

scholarly journals Colorectal cancer survival among Ministry of National Guard-Health Affairs (MNG-HA) population 2009–2017: retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mesnad Alyabsi ◽  
Fouad Sabatin ◽  
Majed Ramadan ◽  
Abdul Rahman Jazieh
Keyword(s):  
Colorectal Cancer ◽  
Distant Metastasis ◽  
Cancer Survival ◽  
National Guard ◽  
Population Based ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Cox Proportional Hazard Models

Abstract Background Colorectal cancer (CRC) is the most diagnosed cancer among males and third among females in Saudi Arabia, with up to two-third diagnosed at advanced stage. The objective of our study was to estimate CRC survival and determine prognostic factors. Methods Ministry of National Guard- Health Affairs (MNG-HA) registry data was utilized to identify patients diagnosed with CRC between 2009 and 2017. Cases were followed until December 30th, 2017 to assess their one-, three-, and five-year CRC-specific survivals. Kaplan-Meier method and Cox proportional hazard models were used to assess survival from CRC. Results A total of 1012 CRC patients were diagnosed during 2009–2017. Nearly, one-fourth of the patients presented with rectal tumor, 42.89% with left colon and 33.41% of the cases were diagnosed at distant metastasis stage. The overall one-, three-, and five-year survival were 83, 65 and 52.0%, respectively. The five-year survival was 79.85% for localized stage, 63.25% for regional stage and 20.31% for distant metastasis. Multivariate analyses showed that age, diagnosis period, stage, nationality, basis of diagnosis, morphology and location of tumor were associated with survival. Conclusions Findings reveal poor survival compared to Surveillance, Epidemiology, and End Results (SEER) population. Diagnoses at late stage and no surgical and/or perioperative chemotherapy were associated with increased risk of death. Population-based screening in this population should be considered.

scholarly journals Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas

ESMO Open ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. e001035
Author(s):  
Herbert Ho-fung Loong ◽  
Carlos King Ho Wong ◽  
Yihui Wei ◽  
Sampson Sui Chun Kwan ◽  
Yingjun Zhang ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Bone Sarcoma ◽  
Population Based ◽  
Prognostic Impact ◽  
Negative Effects ◽  
Blood Indices ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Comorbidity Index ◽  
Cancer Specific Mortality

BackgroundThe prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.MethodsA population-based database was assembled to extract patients with sarcoma in Hong Kong between January 2004 and March 2018. Charlson’s Comorbidity Index (CCI) score and prevalence of comorbidities, neutrophil, lymphocyte and platelet counts at diagnosis were assessed. The prognostic values of CCI, neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) were estimated using Cox proportional hazard models. Restricted cubic spline plots were used to explore the association of baseline NLR and PLR with all-cause and cancer-specific mortality.ResultsAmong 3358 eligible patients with sarcomas, 52.2% died after a median 26 months of follow-up. The most common comorbidities were diabetes mellitus (9.8%) and cerebrovascular disease (4.8%). Patients with higher CCI had higher mortality (CCI=3 vs CCI=2; HR 1.49; 95% CI 1.19 to 1.87; p<0.01; CCI ≥7 vs CCI =2; HR 3.20; 95% CI 2.62 to 3.92; p<0.001). Abnormal NLR and PLR levels were associated with higher all-cause mortality (NLR: HR 1.698, p<0.001, 95% CI 1.424 to 2.025; PLR: HR 1.346, p<0.001, 95% CI 1.164 to 1.555) and cancer-related mortality (NLR: HR 1.648, p<0.001, 95% CI 1.341 to 2.024; PLR: HR 1.430, p<0.001, 95% CI 1.205 to 1.697).ConclusionsThis is the largest population-based soft-tissue or bone sarcoma cohort worldwide. Comorbidities have significant negative prognostic impact on the survival of patients with sarcomas. Moreover, NLR and PLR are robust prognostic factors, and abnormal NLR and PLR have negative effects yet non-linear effects on survival.

scholarly journals Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2820
Author(s):  
Daniel Redondo-Sánchez ◽  
Rafael Marcos-Gragera ◽  
Marià Carulla ◽  
Arantza Lopez de Munain ◽  
Consol Sabater Gregori ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Socioeconomic Status ◽  
Cancer Incidence ◽  
Breast Cancer Incidence ◽  
Cancer Registries ◽  
Population Based ◽  
Multilevel Study ◽  
Increased Risk ◽  
Incident Cases

Socioeconomic inequalities in cancer incidence are not well documented in southern Europe. We aim to study the association between socioeconomic status (SES) and colorectal, lung, and breast cancer incidence in Spain. We conducted a multilevel study using data from Spanish population-based cancer registries, including incident cases diagnosed for the period 2010–2013 in nine Spanish provinces. We used Poisson mixed-effects models, including the census tract as a random intercept, to derive cancer incidence rate ratios by SES, adjusted for age and calendar year. Male adults with the lowest SES, compared to those with the highest SES, showed weak evidence of being at increased risk of lung cancer (risk ratio (RR): 1.18, 95% CI: 0.94–1.46) but showed moderate evidence of being at reduced risk of colorectal cancer (RR: 0.84, 95% CI: 0.74–0.97). Female adults with the lowest SES, compared to those with the highest SES, showed strong evidence of lower breast cancer incidence with 24% decreased risk (RR: 0.76, 95% CI: 0.68–0.85). Among females, we did not find evidence of an association between SES and lung or colorectal cancer. The associations found between SES and cancer incidence in Spain are consistent with those obtained in other European countries.

scholarly journals The Influence of Early Menopause on Cardiovascular Risk in Women with Rheumatoid Arthritis

2014 ◽  
Vol 41 (7) ◽  
pp. 1270-1275 ◽  
Author(s):  
Emily C. Pfeifer ◽  
Cynthia S. Crowson ◽  
Shreyasee Amin ◽  
Sherine E. Gabriel ◽  
Eric L. Matteson
Keyword(s):  
Rheumatoid Arthritis ◽  
Hormone Replacement ◽  
Population Based ◽  
Proportional Hazard ◽  
Inception Cohort ◽  
Early Menopause ◽  
American College Of Rheumatology ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Models

Objective.Early menopause is associated with an increased risk for developing rheumatoid arthritis (RA). The risk for cardiovascular disease (CVD) in women increases following menopause. Because RA is associated with an increased risk of CVD, this study was undertaken to determine whether early menopause affects the risk of developing CVD in women with RA.Methods.A population-based inception cohort of 600 women with RA who fulfilled 1987 American College of Rheumatology criteria for RA between 1955 and 2007 and were age ≥ 45 years at diagnosis was assembled and followed. Age at menopause and duration of hormone replacement therapy, along with occurrence of CVD, was ascertained by review of medical records. Cox proportional hazard models compared women who underwent early menopause (natural or artificial menopause at age ≤ 45 yrs) to those within the cohort who did not undergo early menopause.Results.Of 600 women, 79 experienced early menopause. Women who underwent early menopause were at significantly higher risk for developing CVD when compared to women who did not (HR 1.56; 95% CI 1.08–2.26).Conclusion.The risk of CVD in women with RA was higher in those who experienced early menopause, and like other known risk factors should increase clinician concern for development of CVD in these patients.

scholarly journals The risk of metachronous cancers in patients with small-intestinal carcinoid tumors: a US population-based study

2012 ◽  
Vol 19 (3) ◽  
pp. 381-387 ◽  
Author(s):  
Sunil Amin ◽  
Richard R P Warner ◽  
Steven H Itzkowitz ◽  
Michelle Kang Kim
Keyword(s):  
Small Bowel ◽  
Population Based ◽  
Proportional Hazard ◽  
Population Based Study ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Before And After ◽  
Cox Proportional Hazard Models ◽  
Small Intestinal

Small-intestinal carcinoids (SIC) are the most common small-bowel malignancies. We sought to determine the risk of developing SIC before and after other primary malignancies (PM) and the prognosis of patients with SIC, with and without another PM. We used the Surveillance, Epidemiology, and End Results database to identify patients diagnosed with SICs between 1973 and 2007. Multiple primary-standardized incidence ratios were calculated as an approximation of relative risk (RR) to explore the association of SICs with metachronous malignancies. Survival analysis was performed using Kaplan–Meier methods and Cox proportional-hazard models. Among 8331 patients with SICs, 2424 (29%) had another PM at some time. The most common sites were prostate (26.2%), breast (14.3%), colon (9.1%), lung/bronchus (6.3%), and bladder (5.3%). Overall, 67% of patients had a PM diagnosed before SIC (pre-SIC), 33% after SIC (post-SIC), and 8% had a PM both before and after SIC. Among the pre-SIC group, the risk of future SIC was increased after cancers of the small bowel (RR 11.86 (95% CI: 6.13–20.72)), esophagus (4.05 (1.10–10.36)), colon (1.39 (1.05–1.81)), kidney (1.93 (1.12–3.09)), prostate (1.38 (1.17–1.62)), and leukemia (2.15 (1.18–3.61)). Among the post-SIC group, there was an increased risk of future PM of the small bowel (8.78 (4.54–15.34)), liver (2.49 (1.08–4.91)), prostate (1.25 (1.0–1.53)), and thyroid (2.73 (1.10–5.62)). Compared to patients with only SIC, those with a PM pre-SIC had worse mean survival (57.9 vs 40.9 months, HR 1.55 (1.42–1.69), P<0.001). In conclusion, almost one-third of patients with SICs have an associated metachronous primary tumor. When these primaries occur prior to (but not after) the SIC diagnosis, the prognosis is worse than with an initial SIC. The type of malignancies associated with SICs may guide future screening efforts.

scholarly journals Risk of early neurodevelopmental disorders associated with in utero exposure to valproate and other antiepileptic drugs: a nationwide cohort study in France

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Joël Coste ◽  
Pierre-Olivier Blotiere ◽  
Sara Miranda ◽  
Yann Mikaeloff ◽  
Hugo Peyre ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiepileptic Drugs ◽  
Neurodevelopmental Disorders ◽  
Speech Therapy ◽  
Population Based ◽  
In Utero ◽  
In Utero Exposure ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Models

Abstract Information available on the risks of neurodevelopmental disorders (NDs) associated with in utero exposure to valproate (VPA) and to other antiepileptic drugs (AEDs) is limited. A nationwide population-based cohort study was conducted based on comprehensive data of the French National Health Data System (SNDS). Liveborn infants without brain malformation, born between January 2011 and December 2014, were followed from birth up to December 2016. NDs were identified based on diagnoses of mental or behavioural disorders and utilization of speech therapy, orthoptic or psychiatric services. The risk of NDs was compared between children exposed in utero to AED monotherapy and unexposed children, using Cox proportional hazard models adjusted for maternal and neonatal characteristics. The cohort included 1,721,990 children, 8848 of whom were exposed in utero to AED monotherapy. During a mean follow-up of 3.6 years, 15,458 children had a diagnosis of mental or behavioural disorder. In utero exposure to VPA was associated with an increased risk of NDs overall (aHR: 3.7; 95% CI 2.8–4.9) and among children born to a mother without mental illness (aHR 5.1; 95% CI 3.6–7.3). A dose–response relationship was demonstrated and the risk of NDs was more particularly increased for an exposure to VPA during the second or third trimesters of pregnancy. Among the other AEDs, only pregabalin was consistently associated with an increased risk of NDs (aHR: 1.5; 95% CI 1.0–2.1). This study confirms a four to fivefold increased risk of early NDs associated with exposure to VPA during pregnancy. The risk associated with other AEDs appears much lower.

scholarly journals Adjuvant Hormonotherapy and Cardiovascular Risk in Post-Menopausal Women with Breast Cancer: A Large Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2254
Author(s):  
Matteo Franchi ◽  
Roberta Tritto ◽  
Luigi Tarantini ◽  
Alessandro Navazio ◽  
Giovanni Corrao
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Adjuvant Therapy ◽  
Large Population ◽  
Positive Association ◽  
Population Based ◽  
Study Cohort ◽  
Increased Risk ◽  
Post Menopausal ◽  
New Diagnosis

Background: Whether aromatase inhibitors (AIs) increase the risk of cardiovascular (CV) events, compared to tamoxifen, in women with breast cancer is still debated. We evaluated the association between AI and CV outcomes in a large population-based cohort of breast cancer women. Methods: By using healthcare utilization databases of Lombardy (Italy), we identified women ≥50 years, with new diagnosis of breast cancer between 2009 and 2015, who started adjuvant therapy with either AI or tamoxifen. We estimated the association between exposure to AI and CV outcomes (including myocardial infarction, ischemic stroke, heart failure or any CV event) by a Cox proportional hazard model with inverse probability of treatment and censoring weighting. Results: The study cohort included 26,009 women starting treatment with AI and 7937 with tamoxifen. Over a median follow-up of 5.8 years, a positive association was found between AI and heart failure (Hazard Ratio = 1.20, 95% CI: 1.02 to 1.42) and any CV event (1.14, 1.00 to 1.29). The CV risk increased in women with previous CV risk factors, including hypertension, diabetes and dyslipidemia. Conclusions: Adjuvant therapy with AI in breast cancer women aged more than 50 years is associated with increased risk of heart failure and combined CV events.

Sign in / Sign up

Export Citation Format

Share Document