Abstract
PurposeStudies on the association between the use of calcium channel blockers (CCBs) and breast cancer risk have reported inconsistent results. We quantitatively assessed this association by conducting a meta-analysis based on the evidence from observational studies.MethodsWe searched PubMed, MEDLINE, EMBASE and the Cochrane Library for relevant studies published up to and including December 31, 2013. We calculated pooled risk ratios (RRs) for cancer risk.ResultsA total of 17 studies (9 cohort studies, 8 case-control studies) were selected for further study. These studies included 149,607 female subjects, of which 53,812 were CCBs users, who were followed for 2–16 years. The risks of breast cancer among patients receiving CCBs were significantly different for the pooled RRs (95% confidence interval) of cohort studies 1.08 (0.95, 1.20) and case-control studies 0.98 (0.86, 1.09). Differences were also noted for cancer risk, for CCBs use of <5 years 0.96 (0.78, 1.15), and for >5 years 1.01 (0.74, 1.28), as well as for ever used 1.08 (0.95, 1.20), and for current use 1.13 (0.83, 1.42). The RR for studies longer than 10 years was 1.71 (1.01, 2.42), and for studies evaluating nifedipine was 1.10 (0.87, 1.33) and diltiazem was 0.75 (0.40, 1.10).ConclusionsThe long-term use of CCBs appears to have a significant relationship with breast cancer. Well-designed clinical trials are needed to optimize the doses and types of these drugs needed to minimize their carcinogenic potential.
Highlights
Breast cancer is by far the most common cancer diagnosed in women and the most common cause of death in women worldwide [1,2]
‘‘cancer(s)’’ or ‘‘neoplasm(s)’’ or ‘‘malignancy(ies)’’ or ‘‘carcinoma’’ in combination with ‘‘calcium channel blockers’’ or ‘‘verapamil’’ or ‘‘diltiazem’’ or ‘‘nifedipine’’ or ‘‘dihydropyridines’’ or ‘‘amlodipine’’ to identify the studies related to Calcium channel blockers (CCBs) and breast cancer risk
Articles were excluded from the analysis if they had insufficient published data for determining an estimate of relative risk (RR) and confidence interval (CI)
Summary
Breast cancer is by far the most common cancer diagnosed in women (ranking second for both sexes combined) and the most common cause of death in women (ranking fifth for both sexes combined) worldwide [1,2]. Breast cancer is the leading cause of cancer-related mortality among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer [4]. CCBs are used to treat esophageal diseases [7]. These drugs are potent drugs that affect various organ systems, and can cause constipation [8], increase the risk of hemorrhage [9], and impair differentiation during embryogenesis [10]. Cases of lupus after use of diltiazem have been reported [11]
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