Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer

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http://hdl.handle.net/10138/224491

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Kinnunen , P T T , Murtola , T J , Talala , K , Taari , K , Tammela , T L J & Auvinen , A 2017 , ' Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer ' , BMC Cancer , vol. 17 , 585 . https://doi.org/10.1186/s12885-017-3579-8

Title: Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer
Author: Kinnunen, Pete T. T.; Murtola, Teemu J.; Talala, Kirsi; Taari, Kimmo; Tammela, Teuvo L. J.; Auvinen, Anssi
Contributor: University of Helsinki, Clinicum
Date: 2017-08-29
Language: eng
Number of pages: 9
Belongs to series: BMC Cancer
ISSN: 1471-2407
URI: http://hdl.handle.net/10138/224491
Abstract: Background: Venous thromboembolic events (VTE) are common in cancer patients and associated with higher mortality. In vivo thrombosis and anticoagulation might be involved in tumor growth and progression. We studied the association of warfarin and other anticoagulant use as antithrombotic medication and prostate cancer (PCa) death in men with the disease. Methods: The study included 6,537 men diagnosed with PCa during 1995-2009. Information on anticoagulant use was obtained from a national reimbursement registry. Cox regression with adjustment for age, PCa risk group, primary therapy and use of other medication was performed to compare risk of PCa death between warfarin users with 1) men using other types of anticoagulants and 2) non-users of anticoagulants. Medication use was analyzed as a time-dependent variable to minimize immortal time bias. Results: In total, 728 men died from PCa during a median follow-up of 9 years. Compared to anticoagulant nonusers, post-diagnostic use of warfarin was associated with an increased risk of PCa death (overall HR 1.47, 95% CI 1. 13-1.93). However, this was limited to low-dose, low-intensity use. Otherwise, the risk was similar to anticoagulant non-users. Additionally, we found no risk difference between warfarin and other types of anticoagulants. Pre-diagnostic use of warfarin was not associated with the risk of PCa death. Conclusions: We found no reduction in risk of PCa death associated with warfarin use. Conversely, the risk was increased in short-term use, which is probably explained by a higher risk of thrombotic events prompting warfarin use in patients with terminal PCa.
Subject: Prostate cancer
Warfarin
Anticoagulant
Survival
Cohort
VENOUS THROMBOEMBOLISM
PROSPECTIVE COHORT
MORTALITY
INHIBITION
ANTICOAGULATION
METASTASIS
CONSORTIUM
THROMBOSIS
BREAST
GRADE
3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
urology
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