Tuesley Karen M, Spilsbury Katrina, Webb Penelope M, Protani Melinda M, Dixon-Suen Suzanne, Pearson Sallie-Anne, Donovan Peter, Coory Michael D, Steer Christopher B, Stewart Louise M, Pandeya Nirmala, Jordan Susan J
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia; Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia.
Cancer Epidemiol. 2023 Oct;86:102444. doi: 10.1016/j.canep.2023.102444. Epub 2023 Aug 16.
Epithelial ovarian cancer (EOC) has few modifiable risk factors. There is evidence that some antihypertensive medicines may have cancer preventive and/or therapeutic actions; therefore, we assessed the associations between use of different antihypertensive medicines and risk of specific EOC histotypes.
Our nested case-control study of linked administrative health data included 6070 Australian women aged over 50 years diagnosed with EOC from 2004 to 2013, and 30,337 matched controls. We used multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for the association between ever use of each antihypertensive medicine group, including beta-adrenergic blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, and alpha blockers, and the risk of EOC overall and separately for the serous, endometrioid, mucinous, clear cell and other histotypes.
We found that most antihypertensive medicines were not associated with risk of EOC. However, women who used calcium channel blockers had a reduced risk of serous EOC (OR= 0.89, 95 % CI:0.81,0.98) and use of combination thiazide and potassium-sparing diuretics was associated with an increased risk of endometroid EOC (OR= 2.09, 95 % CI:1.15,3.82).
Our results provide little support for a chemo-preventive role for most antihypertensives, however, the histotype-specific associations we found warrant further investigation.
上皮性卵巢癌(EOC)几乎没有可改变的风险因素。有证据表明,一些抗高血压药物可能具有癌症预防和/或治疗作用;因此,我们评估了不同抗高血压药物的使用与特定EOC组织学类型风险之间的关联。
我们对关联行政健康数据进行的巢式病例对照研究纳入了2004年至2013年期间确诊为EOC的6070名50岁以上澳大利亚女性以及30337名匹配对照。我们使用多变量条件逻辑回归来估计每组抗高血压药物(包括β-肾上腺素能阻滞剂、血管紧张素转换酶抑制剂、血管紧张素II受体阻滞剂、钙通道阻滞剂、利尿剂和α受体阻滞剂)的既往使用与EOC总体风险以及浆液性、子宫内膜样、黏液性、透明细胞和其他组织学类型风险之间关联的比值比(OR)和95%置信区间(CI)。
我们发现大多数抗高血压药物与EOC风险无关。然而,使用钙通道阻滞剂的女性浆液性EOC风险降低(OR = 0.89,95%CI:0.81,0.98),而联合使用噻嗪类和保钾利尿剂与子宫内膜样EOC风险增加相关(OR = 2.09,95%CI:1.15,3.82)。
我们的结果几乎没有支持大多数抗高血压药物具有化学预防作用,然而,我们发现的组织学类型特异性关联值得进一步研究。