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Does β‐adrenoceptor blocker therapy improve cancer survival? Findings from a population‐based retrospective cohort study
Author(s) -
Shah Sunil M.,
Carey Iain M.,
Owen Christopher G.,
Harris Tess,
DeWilde Stephen,
Cook Derek G.
Publication year - 2011
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.2011.03980.x
Subject(s) - medicine , cancer , breast cancer , prostate cancer , oncology , population , retrospective cohort study , pancreatic cancer , lung cancer , environmental health
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • In vitro studies suggest that β‐adrenoceptor blocker therapy inhibits cancer cell proliferation and migration leading to their consideration as novel therapeutic agents for cancer. • While trials in humans have suggested β‐adrenoceptor blockers have no effect on cancer incidence, their effect on cancer survival has not been studied. • Recent limited evidence in breast cancer patients suggests that β‐adrenoceptor blockers may improve cancer‐specific survival. WHAT THIS STUDY ADDS • This study is the first to examine cancer survival in patients receiving β‐adrenoceptor blockers across a range of common cancers in a large population‐based sample. • For common tumour sites, including lung, breast and colon, there was no evidence that β‐adrenoceptor blocker treatment modified overall survival but poorer survival was seen in patients with prostate and pancreatic cancer. • Our findings do not support development of clinical trials on β‐adrenoceptor blocker therapy for cancer without further evidence of a beneficial effect in humans. AIMS To examine the effect of β‐adrenoceptor blocker treatment on cancer survival. METHODS In a UK primary care database, we compared patients with a new cancer diagnosis receiving β‐adrenoceptor blockers regularly ( n = 1406) with patients receiving other antihypertensive medication ( n = 2056). RESULTS Compared with cancer patients receiving other antihypertensive medication, patients receiving β‐adrenoceptor blocker therapy experienced slightly poorer survival (HR = 1.18, 95% CI 1.04, 1.33 for all β‐adrenoceptor blockers; HR = 1.21, 95% CI 0.94, 1.55 for non‐selective β‐adrenoceptor blockers). This poorer overall survival was explained by patients with pancreatic and prostate cancer with no evidence of an effect on survival for patients with lung, breast or colorectal cancer. Analysis in a cancer‐free matched parallel cohort did not suggest selection bias masked a beneficial effect. CONCLUSION Our study does not support the hypothesis that β‐adrenoceptor blockers improve survival for common cancers.