Assessing the effects of beta-blockers on pancreatic cancer risk: A nested case-control study

Pharmacoepidemiol Drug Saf. 2020 May;29(5):599-604. doi: 10.1002/pds.4993. Epub 2020 Mar 20.

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 β1 -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.

Keywords: beta-blockers; pancreas; pancreatic cancer; pancreatic cancer risk; pharmacoepidemiology.

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects*
  • Aged
  • Case-Control Studies
  • Databases, Factual
  • Female
  • Humans
  • Israel / epidemiology
  • Logistic Models
  • Male
  • Pancreatic Neoplasms / epidemiology*
  • Pancreatic Neoplasms / etiology
  • Risk Factors

Substances

  • Adrenergic beta-Antagonists