1. Warfarin use and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer.
- Author
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Kinnunen PT, Murtola TJ, Talala K, Taari K, Tammela TL, and Auvinen A
- Subjects
- Aged, Early Detection of Cancer, Finland epidemiology, Humans, Male, Middle Aged, Neoplasm Grading, Neoplasm Metastasis, Prostatic Neoplasms diagnosis, Risk Factors, Time Factors, Anticoagulants administration & dosage, Prostatic Neoplasms epidemiology, Prostatic Neoplasms pathology, Warfarin administration & dosage
- Abstract
Objective: Anticoagulants, especially vitamin K antagonists (VKAs) such as warfarin, have been hypothesized to have antitumor properties, and use of VKAs has been associated with a lower prostate cancer (PCa) risk. This study estimated PCa risk among users of warfarin and other anticoagulants., Materials and Methods: All anticoagulant use among 78,615 men during 1995-2009 was analyzed. Cox regression, adjusted for age, screening trial arm and use of other medications, with medication use as a time-dependent variable, was used to estimate PCa risk overall, and by tumor grade and stage., Results: In total, 6537 men were diagnosed with PCa during 1995-2009 (1210 among warfarin users). Compared to non-users, warfarin use was associated with an increased risk of PCa [multivariable-adjusted hazard ratio (HR) = 1.11, 95% confidence interval (CI) 1.01-1.22]. This was limited to short-term, low-dose use, and was not observed in long-term use. A similar overall risk increase was observed for Gleason grade 7-10 PCa. Low-dose, short-term use of warfarin was associated with an increased risk of metastatic PCa. However, the increase in risk vanished with continued use. Compared to other anticoagulants, low-dose use of warfarin was associated with a slightly elevated overall PCa risk (HR = 1.19, 95% CI 1.00-1.43). The increase in risk disappeared in long-term, high-dose use., Conclusions: This study, which included a larger number of PCa cases with warfarin exposure than previous studies, does not support previous notions of decreased risk of PCa among warfarin users. A similar risk of PCa was found among warfarin users and the general population, and no difference in risk was found between warfarin and other anticoagulants.
- Published
- 2016
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