Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence

Controversy exists regarding the potential association between taking calcium channel blockers (CCBs) and the development of breast cancer. As a positive association would have important public health implications due to the widespread use of CCBs, this study aimed to incorporate new evidence to det...

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Main Authors: Wright, Cameron, Moorin, Rachael, Chowdhury, E., Stricker, B., Reid, Christopher, Saunders, C., Hughes, Jeffery
Format: Journal Article
Published: Elsevier Inc. 2017
Online Access:http://hdl.handle.net/20.500.11937/56776
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author Wright, Cameron
Moorin, Rachael
Chowdhury, E.
Stricker, B.
Reid, Christopher
Saunders, C.
Hughes, Jeffery
author_facet Wright, Cameron
Moorin, Rachael
Chowdhury, E.
Stricker, B.
Reid, Christopher
Saunders, C.
Hughes, Jeffery
author_sort Wright, Cameron
building Curtin Institutional Repository
collection Online Access
description Controversy exists regarding the potential association between taking calcium channel blockers (CCBs) and the development of breast cancer. As a positive association would have important public health implications due to the widespread use of CCBs, this study aimed to incorporate new evidence to determine whether an association is likely to exist. We searched MEDLINE, EMBASE and the Cochrane Library to 28 June 2016 for relevant literature. References and citing articles were checked and authors contacted as necessary. Two authors independently selected articles and extracted data. Twenty-nine studies were reviewed; 26 were non-randomised studies (NRS). Meta-analysis of study data where adjustment for ‘confounding by indication’ was judged to be present suggests that an association, if any, is likely to be modest in magnitude (pooled odds/risk ratio 1.09 (95% confidence interval (CI) 1.03–1.15, I 2 = 0%, 8 sub-studies; pooled hazard ratio 0.99 (95% CI 0.94–1.03, I 2 = 35%, 9 sub-studies)). There are credible study data showing an increased relative risk with long-term use of CCBs, but the results of our meta-analysis and of meta-regression of log relative risk against minimum follow-up time are mixed. The current summative evidence does not support a clear association between taking CCBs and developing breast cancer. However, uncertainty remains, especially for long-term use and any association might not be uniform between different populations and/or breast cancer sub-types. We t hus recommend further NRS in settings where CCB use is highly prevalent and population-based cancer, prescription and health-registries exist, to resolve this continuing uncertainty. PROSPERO, CRD42015026712.
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spelling curtin-20.500.11937-567762018-09-03T02:28:47Z Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence Wright, Cameron Moorin, Rachael Chowdhury, E. Stricker, B. Reid, Christopher Saunders, C. Hughes, Jeffery Controversy exists regarding the potential association between taking calcium channel blockers (CCBs) and the development of breast cancer. As a positive association would have important public health implications due to the widespread use of CCBs, this study aimed to incorporate new evidence to determine whether an association is likely to exist. We searched MEDLINE, EMBASE and the Cochrane Library to 28 June 2016 for relevant literature. References and citing articles were checked and authors contacted as necessary. Two authors independently selected articles and extracted data. Twenty-nine studies were reviewed; 26 were non-randomised studies (NRS). Meta-analysis of study data where adjustment for ‘confounding by indication’ was judged to be present suggests that an association, if any, is likely to be modest in magnitude (pooled odds/risk ratio 1.09 (95% confidence interval (CI) 1.03–1.15, I 2 = 0%, 8 sub-studies; pooled hazard ratio 0.99 (95% CI 0.94–1.03, I 2 = 35%, 9 sub-studies)). There are credible study data showing an increased relative risk with long-term use of CCBs, but the results of our meta-analysis and of meta-regression of log relative risk against minimum follow-up time are mixed. The current summative evidence does not support a clear association between taking CCBs and developing breast cancer. However, uncertainty remains, especially for long-term use and any association might not be uniform between different populations and/or breast cancer sub-types. We t hus recommend further NRS in settings where CCB use is highly prevalent and population-based cancer, prescription and health-registries exist, to resolve this continuing uncertainty. PROSPERO, CRD42015026712. 2017 Journal Article http://hdl.handle.net/20.500.11937/56776 10.1016/j.canep.2017.08.012 Elsevier Inc. fulltext
spellingShingle Wright, Cameron
Moorin, Rachael
Chowdhury, E.
Stricker, B.
Reid, Christopher
Saunders, C.
Hughes, Jeffery
Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence
title Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence
title_full Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence
title_fullStr Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence
title_full_unstemmed Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence
title_short Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence
title_sort calcium channel blockers and breast cancer incidence: an updated systematic review and meta-analysis of the evidence
url http://hdl.handle.net/20.500.11937/56776