Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer

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Kinnunen , P T T , Murtola , T J , Talala , K , Taari , K , Tammela , T L J & Auvinen , A 2019 , ' Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer ' , Cancer Causes & Control , vol. 30 , no. 8 , pp. 877-888 .

Title: Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer
Author: Kinnunen, P. T. T.; Murtola, T. J.; Talala, K.; Taari, K.; Tammela, T. L. J.; Auvinen, A.
Contributor organization: HUS Abdominal Center
University Management
Urologian yksikkö
Department of Surgery
Date: 2019-08
Language: eng
Number of pages: 12
Belongs to series: Cancer Causes & Control
ISSN: 0957-5243
Abstract: PurposeAnticoagulants may reduce mortality of cancer patients, though the evidence remains controversial. We studied the association between different anticoagulants and cancer death.MethodsAll 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.ResultsDuring a median follow-up of 17.2years, 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.ConclusionOur 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.
Subject: Cancer mortality
Low-molecular weight heparins
3122 Cancers
3142 Public health care science, environmental and occupational health
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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