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Prostate cancer incidence and mortality in men exposed to α1-adrenergic receptor antagonists.
- Source :
-
Journal of the National Cancer Institute [J Natl Cancer Inst] 2024 Sep 01; Vol. 116 (9), pp. 1459-1465. - Publication Year :
- 2024
-
Abstract
- Background: α1-Adrenergic receptor antagonists are commonly used to treat benign prostatic hyperplasia. Preclinical studies suggest that they induce cell death and inhibit tumor growth. This study evaluated the risk of prostate cancer death in men using α1-adrenergic receptor antagonists.<br />Methods: A population-based cohort study in Stockholm, Sweden (January 1, 2007, to December 31, 2019) included 451 779 men with a prostate-specific antigen test result. Study entry was 1 year after the first prostate-specific antigen test. Men were considered exposed at their second filled prescription. The primary outcome was prostate cancer mortality. Secondary outcomes were all-cause mortality and prostate cancer incidence. Cox proportional hazards regression models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all outcomes. Inverse-probability weighting with marginal structural models accounted for time-dependent confounders.<br />Results: Of 351 297 men in the final cohort, 39 856 (11.3%) were exposed to α1-adrenergic receptor antagonists. Median (interquartile range) follow-up for prostate cancer mortality was 8.9 (5.1-10.9) years; median (interquartile range) exposure time to α1-adrenergic receptor antagonists was 4.4 (2.0-7.6) years. There was no evidence of an association between α1-adrenergic receptor antagonist use and prostate cancer mortality, all-cause mortality, or high-grade prostate cancer. α1-Adrenergic receptor antagonist use was associated with an increased risk of prostate cancer (HR = 1.11, 95% CI = 1.06 to 1.17) and low-grade prostate cancer (HR = 1.22, 95% CI = 1.11 to 1.33). Men whose prostate cancer was treated with α1-adrenergic receptor antagonists underwent more frequent prostate-specific antigen testing.<br />Conclusions: Our findings show no significant association between α1-adrenergic receptor adrenoceptor antagonist exposure and prostate cancer mortality or high-grade prostate cancer. Although the preclinical evidence indicates a potential chemopreventive effect, this study's findings do not support it.<br /> (© The Author(s) 2024. Published by Oxford University Press.)
- Subjects :
- Humans
Male
Aged
Sweden epidemiology
Incidence
Middle Aged
Prostate-Specific Antigen blood
Cohort Studies
Proportional Hazards Models
Prostatic Hyperplasia drug therapy
Prostatic Hyperplasia mortality
Prostatic Hyperplasia epidemiology
Follow-Up Studies
Prostatic Neoplasms mortality
Prostatic Neoplasms epidemiology
Prostatic Neoplasms pathology
Prostatic Neoplasms drug therapy
Adrenergic alpha-1 Receptor Antagonists therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2105
- Volume :
- 116
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of the National Cancer Institute
- Publication Type :
- Academic Journal
- Accession number :
- 38718219
- Full Text :
- https://doi.org/10.1093/jnci/djae108