Assessing the effects of beta‐blockers on pancreatic cancer risk: A nested case‐control study
Akram Saad, Jeffrey Goldstein, Ofer Margalit, Einat Shacham‐Shmueli, Yaacov Richard Lawrence, Yu‐Xiao Yang, Kim A. Reiss, Talia Golan, Ronac Mamtani, Naama Halpern, Dan Aderka, Meir Mouallem, Adam Lee Goldstein, Bruce J. Giantonio, Ben Boursi
Abstract
Abstract Purpose Both β1‐ and β2‐adrenoceptor proteins were detected on the cell surface of pancreatic ductal adenocarcinoma. The current study evaluated the association between beta‐blocker use and pancreatic cancer risk. Methods We conducted a nested case‐control study in a large population representative database. Each pancreatic cancer case was matched with four controls based on age, sex, practice site, and duration of follow‐up using incidence density sampling. Beta‐blocker use was defined as any prescription prior to index date and was stratified into non‐selective and selective β 1 ‐blockers. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for pancreatic cancer risk associated with beta‐blocker use was estimated using conditional logistic regression. Results The study included 4113 patients with pancreatic cancer and 16 072 matched controls. When compared to never users, there was no association between any beta‐blocker use and pancreatic cancer risk (adjusted OR 1.06, 95% CI 0.97‐1.16, P = .16). Analysis by receptor selectivity showed use of non‐selective beta‐blockers for more than 2 years was associated with a reduced pancreatic cancer risk (OR 0.75, 95% CI 0.57‐1.00, P = .05). When compared to former users both users of selective β1‐blockers and non‐selective beta‐blockers had a reduced pancreatic cancer risk (OR 0.78, 95% CI 0.67‐0.90, P = .001) and (OR 0.67, 95% CI 0.49‐0.92, P = .01), respectively. Conclusion Beta‐blocker use was not associated with increased pancreatic cancer risk. However, long‐term use of beta‐blockers may be associated with decreased pancreatic cancer risk.