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Long-Term Vitamin K Antagonists and Cancer Risk: A Systematic Review and Meta-Analysis.
- Source :
-
American journal of clinical oncology [Am J Clin Oncol] 2019 Sep; Vol. 42 (9), pp. 717-724. - Publication Year :
- 2019
-
Abstract
- Objectives: Vitamin K antagonists (VKAs) remain one of the most commonly used anticoagulation therapies. The potential anticancer effect of long-term use of VKAs has been a matter of debate with conflicting results. Our goal was to perform a systematic review and meta-analysis examining the association between long-term VKAs use and cancer risk.<br />Methods: Systematic searches of multiple major databases were performed from inception until January 2018. We included studies of adults that compared incidence of any cancer between ≥6 months use of VKAs (long-term group) and <6 months use of VKAs or nonuse (control group). Primary outcome was all-cancer incidence and secondary outcomes were cancer-specific incidence, all-cause death and cancer-specific mortality. Hazard ratios (HRs) were pooled using a random-effects model, and individual studies were weighted using inverse variance.<br />Results: We identified 9 observational studies that included 1,521,408 patients. No randomized trials were identified. In comparison to control, long-term use of VKAs was associated with a significant reduction in incidence of all cancers (HR, 0.84; 95% confidence interval [CI], 0.81-0.88; P<0.001). In a prespecified subgroup analysis, long-term use of VKAs demonstrated a significant reduction in all-cancer incidence when compared with control in individuals whose indication for VKAs were venous thromboembolism (HR, 0.69; 95% CI, 0.52-0.90; P=0.007).<br />Conclusions: The use of long-term VKAs, for any indication, is associated with lower cancer incidence. This finding could have important clinical implications for the choice of oral anticoagulation therapies among specific patients with a higher baseline risk of cancer.
Details
- Language :
- English
- ISSN :
- 1537-453X
- Volume :
- 42
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- American journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31313676
- Full Text :
- https://doi.org/10.1097/COC.0000000000000571