Thiazide Diuretics and Risk of Colorectal Cancer: A Population-Based Cohort Study.
antihypertensive drugs
calcium channel blockers
cohort
colorectal cancer
dihydropyridine
propensity score
thiazide diuretics
Journal
American journal of epidemiology
ISSN: 1476-6256
Titre abrégé: Am J Epidemiol
Pays: United States
ID NLM: 7910653
Informations de publication
Date de publication:
11 Aug 2023
11 Aug 2023
Historique:
received:
11
07
2022
revised:
05
05
2023
medline:
14
8
2023
pubmed:
14
8
2023
entrez:
14
8
2023
Statut:
aheadofprint
Résumé
Evidence from clinical trials and observational studies on the association between thiazide diuretics and colorectal cancer risk is conflicting. We aimed to determine whether thiazide diuretics are associated with an increased colorectal cancer risk compared with dihydropyridine calcium channel blockers (dCCBs). A population-based, new-user cohort was assembled using the United Kingdom Clinical Practice Research Datalink. Between 1990-2018, we compared thiazide diuretic initiators with dCCB initiators and estimated hazard ratios (HR) with 95% confidence intervals (CIs) of colorectal cancer using Cox proportional hazard models. Models were weighted using standardized morbidity ratio weights generated from calendar time-specific propensity scores. The cohort included 377,760 thiazide diuretic initiators and 364,300 dCCB initiators, generating 3,619,883 person-years of follow-up. Compared with dCCBs, thiazide diuretics were not associated with colorectal cancer (weighted HR:0.97, 95% CI:0.90-1.04). Secondary analyses yielded similar results, although an increased risk was observed among patients with inflammatory bowel disease (weighted HR:2.45, 95% CI:1.13-5.35) and potentially polyps (weighted HR:1.46, 95% CI:0.93-2.30). Compared with dCCBs, thiazide diuretics were not associated with an overall increased colorectal cancer risk. While these findings provide some reassurance, research is needed to corroborate the elevated risks observed among patients with inflammatory bowel disease and history of polyps.
Sections du résumé
BACKGROUND
BACKGROUND
Evidence from clinical trials and observational studies on the association between thiazide diuretics and colorectal cancer risk is conflicting. We aimed to determine whether thiazide diuretics are associated with an increased colorectal cancer risk compared with dihydropyridine calcium channel blockers (dCCBs).
METHODS
METHODS
A population-based, new-user cohort was assembled using the United Kingdom Clinical Practice Research Datalink. Between 1990-2018, we compared thiazide diuretic initiators with dCCB initiators and estimated hazard ratios (HR) with 95% confidence intervals (CIs) of colorectal cancer using Cox proportional hazard models. Models were weighted using standardized morbidity ratio weights generated from calendar time-specific propensity scores.
RESULTS
RESULTS
The cohort included 377,760 thiazide diuretic initiators and 364,300 dCCB initiators, generating 3,619,883 person-years of follow-up. Compared with dCCBs, thiazide diuretics were not associated with colorectal cancer (weighted HR:0.97, 95% CI:0.90-1.04). Secondary analyses yielded similar results, although an increased risk was observed among patients with inflammatory bowel disease (weighted HR:2.45, 95% CI:1.13-5.35) and potentially polyps (weighted HR:1.46, 95% CI:0.93-2.30).
CONCLUSION
CONCLUSIONS
Compared with dCCBs, thiazide diuretics were not associated with an overall increased colorectal cancer risk. While these findings provide some reassurance, research is needed to corroborate the elevated risks observed among patients with inflammatory bowel disease and history of polyps.
Identifiants
pubmed: 37579305
pii: 7241427
doi: 10.1093/aje/kwad171
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.