Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

Cardiac glycosides use and the risk of lung cancer: a nested case–control study

Sébastien Couraud1234, Laurent Azoulay15, Sophie Dell’Aniello1 and Samy Suissa12*

Author Affiliations

1 Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal H3T 1E2, Quebec, Canada

2 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada

3 Pulmonology unit, Lyon Sud hospital, Hospices Civils de Lyon, Pierre Bénite, France

4 The faculty of medicine Lyon-Sud Charles Mérieux, Lyon 1 University, Oullins, France

5 Department of Oncology, McGill University, Montreal, Quebec, Canada

For all author emails, please log on.

BMC Cancer 2014, 14:573  doi:10.1186/1471-2407-14-573

Published: 8 August 2014

Abstract

Background

Two studies have reported statistically significant associations between the use of cardiac glycosides (CGs) and an increased risk of lung cancer. However, these studies had a number of methodological limitations. Thus, the objective of this study was to assess this association in a large population-based cohort of patients.

Methods

We used the United Kingdom Clinical Practice Research Datalink (CPRD) to identify a cohort of patients, at least 40 years of age, newly-diagnosed with heart failure, or supra-ventricular arrhythmia. A nested case–control analysis was conducted where each incident case of lung cancer identified during follow-up was randomly matched with up to 10 controls. Exposure to CGs was assessed in terms of ever use, cumulative duration of use and cumulative dose. Rate ratios (RRs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression after adjusting for potential confounders.

Results

A total of 129,002 patients were included, and followed for a mean (SD) of 4.7 (3.8) years. During follow-up, 1237 patients were newly-diagnosed with lung cancer. Overall, ever use of CGs was not associated with an increased risk of lung cancer when compared to never use (RR = 1.09, 95% CI: 0.94-1.26). In addition, no dose–response relationship was observed in terms of cumulative duration of use and cumulative dose with all RRs around the null value across quartile categories.

Conclusion

The results of this large population-based study indicate that the use of CGs is not associated with an increased risk of lung cancer.

Keywords:
Lung cancer; Cardiac glycoside; Digoxin; Case–control study; Risk factor