Long-term Use of CCB and Breast Cancer Risk
Association of Long-term Use of Calcium Channel Blockers (CCB) and Risk of Breast Cancer: A Retrospective Longitudinal Observational Study
The goal of this retrospective observational study is to examine whether long-term calcium channel blocker (CCB) use is associated with the development of breast cancer amongst women enrolled in three longitudinal cohort studies in Australia and the Netherlands . The main questions it aims to answer are:
- Is long-term CCB use associated with the development of breast cancer amongst women enrolled in three longitudinal cohort studies in Australia and the Netherlands and what is the dose-response nature of this association.
- Does differences in the association between calcium channel blocker use and the development of breast cancer exist between Australian and Dutch women.
The investigators will utilise data from the Australian Longitudinal Study on Women's Health (ALSWH) , 45 and Up Study and Rotterdam study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Aims: To examine the association between long-term calcium channel blocker (CCB) use and the development of breast cancer.
Data sources: the Australian Longitudinal Study on Women's Health , 45 and Up Study, Rotterdam study and linked administrative data.
Study cohort: Women with self-reported hypertension (HTN) without prior breast cancer.
Harmonisation: Relevant variables will be checked for harmonisation in which variables available in all three cohort will be used in the harmonised analysis. The variables will be checked on the definition, measurement and harmonisation rules. Variables that cannot be harmonised across the cohorts will be used in the cohort specific analyses.
Exposure measurement: The primary exposure is the use of CCB, which will be identified by the anatomical therapeutic chemical code (C08) in the medicine data. Exposure to CCB as well as other antihypertensive (AHT) medicines will be captured separately as the cumulative dose-duration of exposure during follow up. Participants will be stratified in four groups: women with HTN with no AHT use, women with HTN exposed to CCB only, women with HTN exposed to non-CCB and women with HTN exposed to both CCB and non-CCB.
Outcome measurement: Data on a diagnosis of invasive breast cancer will be obtained from cancer registries and hospital admission data using ICD-10 code of C50.x.
Potential confounders: age, education, marital status, socioeconomic status, body mass index, diabetes, heart disease, stroke, age when had first child, parity, history of hysterectomy or oophorectomy, use of hormonal contraception, use of hormonal replacement therapy.
Statistical analysis: The association between CCB use and breast cancer risk will be estimated by the Fine and Gray competing risk regression model in which a first diagnosis of invasive breast cancer will be treated as the principle event and death and bilateral mastectomy (without a diagnosis of breast cancer) will be competing risks. The nonlinear threshold models will be used to capture any differential effect of the cumulative dose-duration of CCB while simultaneously accounting for the cumulative dose-duration of other AHT exposure on breast cancer risk. Other confounders will be accounted for in the models using propensity scores.
Implications: Results from this study will contribute to addressing the concerns about using CCB for hypertension treatment in women, particularly in those who have high risk of breast cancer.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Locations
-
-
Western Australia
-
Bentley, Western Australia, Australia, 6102
- Curtin University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion criteria:
- Alive and still enrolled in the longitudinal cohort at the study entry (2004 to 2009)
- Self-reported/diagnosed hypertension at study entry.
Exclusion criteria:
+ A history of breast cancer.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No AHT
Women with HTN with no AHT use
|
None AHT
|
|
AHT but non-CCB
Women with HTN exposed to other antihypertensive medicines but not exposed to calcium channel blockers
|
Drugs with ATC code C07 will be categorised as beta-blockers.
Drugs with ATC code C03 will be categorised as diuretics.
Drugs with ATC code C09 will be categorised as RAS (agents acting on the renin angiotensin system).
Drugs with ATC code C02 will be categorised as other antihypertensives.
|
|
CCB only
Women with HTN exposed to calcium channel blockers but not exposed to other antihypertensive medicines
|
Drugs with ATC code C08 will be categorised as calcium channel blockers.
|
|
Both CCB and non-CCB
Women with HTN exposed to both calcium channel blockers and other antihypertensive medicines.
|
Drugs with ATC code C07 will be categorised as beta-blockers.
Drugs with ATC code C03 will be categorised as diuretics.
Drugs with ATC code C09 will be categorised as RAS (agents acting on the renin angiotensin system).
Drugs with ATC code C02 will be categorised as other antihypertensives.
Drugs with ATC code C08 will be categorised as calcium channel blockers.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incident rate of invasive breast cancer
Time Frame: From cohort entry until the earliest date of one of the following: a diagnosis of invasive breast cancer, bilateral mastectomy (without breast cancer) or death, assessed up to 14 years.
|
The outcome will be defined based on the ICD-10 code of C50.x (malignant neoplasm of breast).
|
From cohort entry until the earliest date of one of the following: a diagnosis of invasive breast cancer, bilateral mastectomy (without breast cancer) or death, assessed up to 14 years.
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Skin Diseases
- Neoplasms
- Neoplasms by Site
- Breast Diseases
- Hypertension
- Breast Neoplasms
- Essential Hypertension
- Physiological Effects of Drugs
- Adrenergic Antagonists
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Natriuretic Agents
- Membrane Transport Modulators
- Calcium-Regulating Hormones and Agents
- Calcium
- Diuretics
- Calcium Channel Blockers
- Adrenergic beta-Antagonists
Other Study ID Numbers
Other Study ID Numbers
- 2014896
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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