Abstract
Contradictory findings exist about association of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) with lung cancer development. This was a retrospective observational cohort study that used data from 7 hospitals in Korea, converted to the Observational Medical Outcomes Partnership Common Data Model. The primary outcome was occurrence of lung cancer. A total of 207,794 patients across the 7 databases was included in the final analysis; 33,230 (16%) were prescribed ACEi and 174,564 (84%) were prescribed ARB. Crude analysis adjusted for sex and age showed higher incidence of lung cancer in the ACEi group compared to the ARB group (hazard ratio [HR], 1.46; 95% confidence rate [CI], 1.08–1.97). After propensity-score matching, 30,445 pairs were generated, and there was no difference in incidence of lung cancer between the two groups (HR, 0.93; 95% CI, 0.64–1.35). Patients prescribed ACEi showed no difference in incidence of lung cancer development compared to those using ARB. This finding provides evidence on the association between ACEi and occurrence of lung cancer.
Highlights
Numerous studies have shown that the Renin–Angiotensin–Aldosterone system (RAAS) affects cancer development[1,2,3]
The RAAS is composed of different receptors and effectors, such as angiotensin type 1 and 2 receptors, pro-renin receptor, and Angiotensin 2, which are associated with angiogenesis and cell proliferation
Several retrospective studies have demonstrated that patients taking the RAAS modifier angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) had a decreased risk of certain type of cancers[6,7]
Summary
Numerous studies have shown that the Renin–Angiotensin–Aldosterone system (RAAS) affects cancer development[1,2,3]. Several retrospective studies have demonstrated that patients taking the RAAS modifier angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) had a decreased risk of certain type of cancers[6,7]. Biological evidence exists for a possible association between ACEIs and increased risk of lung cancer. Several cohort studies have reported that patients prescribed ACEi showed increased lung cancer diagnosis compared to those using A RB8,9. The association between ACEi and lung cancer development is not clear. The objective of this study was to evaluate the association between ACEi prescription and lung cancer development using de-identified databases from 7 hospitals in Korea
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