Olsen J H, Sørensen H T, Friis S, McLaughlin J K, Steffensen F H, Nielsen G L, Andersen M, Fraumeni J F, Olsen J
Danish Cancer Society, Division for Cancer Epidemiology, Copenhagen, Denmark.
Hypertension. 1997 May;29(5):1091-4. doi: 10.1161/01.hyp.29.5.1091.
Ca2+ channel blockers may cause cancer by inhibiting apoptosis or reducing intracellular Ca2+ in certain tissues. Recent findings suggest that drug users are at increased risk for cancer in general and for colon cancer in particular. We conducted a study in one Danish county of 17911 patients who received at least one prescription of Ca2+ channel blockers between 1 January 1991 and 31 December 1993. The patients were identified from records in the National Health Insurance Program, which refunds part of the price of such drugs. Cancer occurrence and rate were determined by use of the files of the Danish Cancer Registry and compared with county-specific incidence rates for various categories of cancer. During the follow-up period of up to 3 years, 412 cancers were observed among users of Ca2+ channel blockers, compared with 414 expected, to yield an age- and sex-standardized incidence ratio (SIR) of 1.00 (95% confidence interval, 0.90 to 1.10). There was no indication of an excess risk in the subgroup of likely long-term users or users of specific drugs. The SIR of colon cancer, a site of a priori interest, was 0.8 (95% confidence interval, 0.5 to 1.1) on the basis of 34 cases. Although the results are reassuring, the lack of association could reflect the relatively short follow-up after registration in the prescription database. Continued monitoring of cancer risk is planned.
钙通道阻滞剂可能通过抑制细胞凋亡或降低某些组织中的细胞内钙离子浓度而导致癌症。最近的研究结果表明，一般而言，药物使用者患癌症的风险增加，尤其是患结肠癌的风险。我们在丹麦的一个县对17911名患者进行了一项研究，这些患者在1991年1月1日至1993年12月31日期间至少接受过一次钙通道阻滞剂处方。这些患者是从国家健康保险计划的记录中识别出来的，该计划会退还此类药物部分费用。癌症的发生情况和发病率通过丹麦癌症登记处的档案确定，并与各县各类癌症的特定发病率进行比较。在长达3年的随访期内，钙通道阻滞剂使用者中观察到412例癌症，而预期为414例，年龄和性别标准化发病率比（SIR）为1.00（95%置信区间，0.90至1.10）。在可能的长期使用者或特定药物使用者亚组中没有发现额外风险的迹象。基于34例病例，先验关注部位结肠癌的SIR为0.8（95%置信区间，0.5至1.1）。尽管结果令人放心，但缺乏关联可能反映了在处方数据库中登记后随访时间相对较短。计划继续监测癌症风险。
