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Open Access Research article

Use of ß-blockers and mortality following ovarian cancer diagnosis: a population-based cohort study

Sigrun A Johannesdottir12*, Morten Schmidt12, Gary Phillips3, Ronald Glaser456, Eric V Yang56, Michael Blumenfeld4 and Stanley Lemeshow12

Author Affiliations

1 Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA

2 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark

3 The Ohio State University, Center for Biostatistics, Columbus, OH, USA

4 The Ohio State University Medical Center, Columbus, OH, USA

5 Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA

6 Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA

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BMC Cancer 2013, 13:85  doi:10.1186/1471-2407-13-85

Published: 22 February 2013

Abstract

Background

Experimental data suggest that catecholamine hormones are involved in stimulating the aggressiveness of ovarian cancer, but few population-based studies have examined this association. We therefore conducted a population-based cohort study to examine whether ß-blockers affect mortality following ovarian cancer diagnosis.

Methods

We used the Danish Cancer Registry to identify all patients diagnosed with ovarian cancer in northern Denmark between 1999 and 2010 (n=6,626). Data on medication use, comorbidity, and survival were obtained from medical databases. According to the last redeemed prescription before diagnosis, ß-blocker use was categorized as current (within ≤90 days), previous (>90 days) or never. We used Cox proportional hazards regression to calculate hazard ratios (HRs) for all-cause mortality with 95% confidence intervals (CIs) adjusting for confounding factors.

Results

Among the ovarian cancer patients, 373 (5.6%) were current, 87 (1.3%) previous, and 6,166 (93.1%) were nonusers of ß-blockers. Median duration of use was 19.0 months among current users and 43.0 months among previous users. Median follow-up was 2.55 years (IQR: 0.81-9.23). Nonusers and current users of ß-blockers had similar comorbidity burden whereas previous users had moderate comorbidity more frequently. Compared with nonusers, the adjusted HR was 1.17 (95% CI: 1.02–1.34) for current users and 1.18 (95% CI: 0.90–1.55) for previous users. Secondary analyses stratifying by cancer stage and duration of ß-blocker use supported the overall results.

Conclusions

We found no evidence that ß-blocker use was associated with decreased mortality following ovarian cancer diagnosis.