Use of vitamin K antagonists and risk of prostate cancer

Meta–analysis and nationwide case–control study

Kasper Bruun Kristensen*, Patricia Hjorslev Jensen, Charlotte Skriver, Søren Friis, Anton Pottegård

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Use of vitamin K antagonists (VKAs) has been suggested to reduce the risk of prostate cancer. We conducted a nested case–control study using Danish demographic and health data registries and summarized existing evidence in a meta-analysis. The case–control study included all Danish men aged 40–85 years with incident histologically verified prostate adenocarcinoma between 2005 and 2015 (cases). For each case, we selected 10 age–matched controls. We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CI) for prostate cancer associated with long–term VKA use adjusted for concomitant drug use, medical history and socioeconomic status. Among 38,832 prostate cancer cases, 1,089 (2.8%) had used VKAs for 3 or more years compared to 10,803 (2.8%) controls yielding a crude OR of 1.01 (95% CI, 0.95–1.08). Multivariable adjustment for covariates had limited influence on the association (OR, 1.03; 95% CI, 0.97–1.10). We observed no dose–response relationship (e.g. OR for 5–10 years of use, 1.06 95% CI, 0.97–1.16). We included 8 studies in the meta–analysis reporting effect estimates from 0.51 (95% CI, 0.23–1.13) to 1.10 (95% CI, 0.94–1.40). Using random effect methods, a pooled effect estimate of 0.86 (95% CI, 0.70–1.05) was obtained; however, there was considerable across–study heterogeneity (I2: 93.9%). In conclusion, we did not observe a reduced risk of prostate cancer associated with VKA use in this nationwide study and, taken together with previous study findings, a major protective effect of VKAs against prostate cancer seems unlikely.

Original languageEnglish
JournalInternational Journal of Cancer
Volume144
Issue number7
Pages (from-to)1522-1529
ISSN0020-7136
DOIs
Publication statusPublished - Apr 2019

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Prostatic Neoplasms
Confidence Intervals
Odds Ratio
Vitamin K 3
Registries
Meta-Analysis
Prostate
Logistic Models
Health
Pharmaceutical Preparations

Keywords

  • anticoagulant drugs
  • case–control studies
  • prostate cancer
  • risk factors
  • warfarin

Cite this

@article{d45b6bbf6cec4578a5728e8481fcacd7,
title = "Use of vitamin K antagonists and risk of prostate cancer: Meta–analysis and nationwide case–control study",
abstract = "Use of vitamin K antagonists (VKAs) has been suggested to reduce the risk of prostate cancer. We conducted a nested case–control study using Danish demographic and health data registries and summarized existing evidence in a meta-analysis. The case–control study included all Danish men aged 40–85 years with incident histologically verified prostate adenocarcinoma between 2005 and 2015 (cases). For each case, we selected 10 age–matched controls. We used conditional logistic regression to estimate odds ratios (ORs) with 95{\%} confidence intervals (CI) for prostate cancer associated with long–term VKA use adjusted for concomitant drug use, medical history and socioeconomic status. Among 38,832 prostate cancer cases, 1,089 (2.8{\%}) had used VKAs for 3 or more years compared to 10,803 (2.8{\%}) controls yielding a crude OR of 1.01 (95{\%} CI, 0.95–1.08). Multivariable adjustment for covariates had limited influence on the association (OR, 1.03; 95{\%} CI, 0.97–1.10). We observed no dose–response relationship (e.g. OR for 5–10 years of use, 1.06 95{\%} CI, 0.97–1.16). We included 8 studies in the meta–analysis reporting effect estimates from 0.51 (95{\%} CI, 0.23–1.13) to 1.10 (95{\%} CI, 0.94–1.40). Using random effect methods, a pooled effect estimate of 0.86 (95{\%} CI, 0.70–1.05) was obtained; however, there was considerable across–study heterogeneity (I2: 93.9{\%}). In conclusion, we did not observe a reduced risk of prostate cancer associated with VKA use in this nationwide study and, taken together with previous study findings, a major protective effect of VKAs against prostate cancer seems unlikely.",
keywords = "anticoagulant drugs, case–control studies, prostate cancer, risk factors, warfarin",
author = "Kristensen, {Kasper Bruun} and Jensen, {Patricia Hjorslev} and Charlotte Skriver and S{\o}ren Friis and Anton Potteg{\aa}rd",
year = "2019",
month = "4",
doi = "10.1002/ijc.31886",
language = "English",
volume = "144",
pages = "1522--1529",
journal = "International Journal of Cancer",
issn = "0020-7136",
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}

Use of vitamin K antagonists and risk of prostate cancer : Meta–analysis and nationwide case–control study. / Kristensen, Kasper Bruun; Jensen, Patricia Hjorslev; Skriver, Charlotte; Friis, Søren; Pottegård, Anton.

In: International Journal of Cancer, Vol. 144, No. 7, 04.2019, p. 1522-1529.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Use of vitamin K antagonists and risk of prostate cancer

T2 - Meta–analysis and nationwide case–control study

AU - Kristensen, Kasper Bruun

AU - Jensen, Patricia Hjorslev

AU - Skriver, Charlotte

AU - Friis, Søren

AU - Pottegård, Anton

PY - 2019/4

Y1 - 2019/4

N2 - Use of vitamin K antagonists (VKAs) has been suggested to reduce the risk of prostate cancer. We conducted a nested case–control study using Danish demographic and health data registries and summarized existing evidence in a meta-analysis. The case–control study included all Danish men aged 40–85 years with incident histologically verified prostate adenocarcinoma between 2005 and 2015 (cases). For each case, we selected 10 age–matched controls. We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CI) for prostate cancer associated with long–term VKA use adjusted for concomitant drug use, medical history and socioeconomic status. Among 38,832 prostate cancer cases, 1,089 (2.8%) had used VKAs for 3 or more years compared to 10,803 (2.8%) controls yielding a crude OR of 1.01 (95% CI, 0.95–1.08). Multivariable adjustment for covariates had limited influence on the association (OR, 1.03; 95% CI, 0.97–1.10). We observed no dose–response relationship (e.g. OR for 5–10 years of use, 1.06 95% CI, 0.97–1.16). We included 8 studies in the meta–analysis reporting effect estimates from 0.51 (95% CI, 0.23–1.13) to 1.10 (95% CI, 0.94–1.40). Using random effect methods, a pooled effect estimate of 0.86 (95% CI, 0.70–1.05) was obtained; however, there was considerable across–study heterogeneity (I2: 93.9%). In conclusion, we did not observe a reduced risk of prostate cancer associated with VKA use in this nationwide study and, taken together with previous study findings, a major protective effect of VKAs against prostate cancer seems unlikely.

AB - Use of vitamin K antagonists (VKAs) has been suggested to reduce the risk of prostate cancer. We conducted a nested case–control study using Danish demographic and health data registries and summarized existing evidence in a meta-analysis. The case–control study included all Danish men aged 40–85 years with incident histologically verified prostate adenocarcinoma between 2005 and 2015 (cases). For each case, we selected 10 age–matched controls. We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CI) for prostate cancer associated with long–term VKA use adjusted for concomitant drug use, medical history and socioeconomic status. Among 38,832 prostate cancer cases, 1,089 (2.8%) had used VKAs for 3 or more years compared to 10,803 (2.8%) controls yielding a crude OR of 1.01 (95% CI, 0.95–1.08). Multivariable adjustment for covariates had limited influence on the association (OR, 1.03; 95% CI, 0.97–1.10). We observed no dose–response relationship (e.g. OR for 5–10 years of use, 1.06 95% CI, 0.97–1.16). We included 8 studies in the meta–analysis reporting effect estimates from 0.51 (95% CI, 0.23–1.13) to 1.10 (95% CI, 0.94–1.40). Using random effect methods, a pooled effect estimate of 0.86 (95% CI, 0.70–1.05) was obtained; however, there was considerable across–study heterogeneity (I2: 93.9%). In conclusion, we did not observe a reduced risk of prostate cancer associated with VKA use in this nationwide study and, taken together with previous study findings, a major protective effect of VKAs against prostate cancer seems unlikely.

KW - anticoagulant drugs

KW - case–control studies

KW - prostate cancer

KW - risk factors

KW - warfarin

U2 - 10.1002/ijc.31886

DO - 10.1002/ijc.31886

M3 - Journal article

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JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

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