Anticoagulants and Breast Cancer Survival: A Nationwide Cohort Study.
Aged
Anticoagulants
/ therapeutic use
Breast Neoplasms
/ complications
Drug Prescriptions
/ statistics & numerical data
Female
Finland
/ epidemiology
Follow-Up Studies
Heparin, Low-Molecular-Weight
/ therapeutic use
Humans
Middle Aged
Registries
/ statistics & numerical data
Retrospective Studies
Risk Factors
Survival Analysis
Venous Thromboembolism
/ drug therapy
Warfarin
/ therapeutic use
Journal
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
ISSN: 1538-7755
Titre abrégé: Cancer Epidemiol Biomarkers Prev
Pays: United States
ID NLM: 9200608
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
02
02
2019
revised:
04
04
2019
accepted:
07
10
2019
pubmed:
28
10
2019
medline:
20
1
2021
entrez:
27
10
2019
Statut:
ppublish
Résumé
Various components of the coagulation cascade have been linked to breast cancer progression. All anticoagulants used from 1995 to 2015 in women ( At a median of 5.8 years after breast cancer diagnosis, 10,900 (15%) women had died from breast cancer. In total, 25,622 (35%) women had used anticoagulants during the study period. Postdiagnostic anticoagulant use increased the risk of breast cancer death (HR = 1.41; 95% confidence interval, 1.33-1.49). The risk was especially high for low-molecular weight heparin, although the effect disappeared in long-term users. Anticoagulant use provides no clinical benefit for breast cancer survival; however, the association between thrombosis and cancer might mask potential survival benefits. Future pharmacoepidemiologic studies should adjust for anticoagulant use. Research should focus on the use of new oral anticoagulants because these are rarely studied and might be associated with improved breast cancer survival.
Sections du résumé
BACKGROUND
Various components of the coagulation cascade have been linked to breast cancer progression.
METHODS
All anticoagulants used from 1995 to 2015 in women (
RESULTS
At a median of 5.8 years after breast cancer diagnosis, 10,900 (15%) women had died from breast cancer. In total, 25,622 (35%) women had used anticoagulants during the study period. Postdiagnostic anticoagulant use increased the risk of breast cancer death (HR = 1.41; 95% confidence interval, 1.33-1.49). The risk was especially high for low-molecular weight heparin, although the effect disappeared in long-term users.
CONCLUSIONS
Anticoagulant use provides no clinical benefit for breast cancer survival; however, the association between thrombosis and cancer might mask potential survival benefits.
IMPACT
Future pharmacoepidemiologic studies should adjust for anticoagulant use. Research should focus on the use of new oral anticoagulants because these are rarely studied and might be associated with improved breast cancer survival.
Identifiants
pubmed: 31653681
pii: 1055-9965.EPI-19-0147
doi: 10.1158/1055-9965.EPI-19-0147
doi:
Substances chimiques
Anticoagulants
0
Heparin, Low-Molecular-Weight
0
Warfarin
5Q7ZVV76EI
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
208-215Informations de copyright
©2019 American Association for Cancer Research.