Oral prednisolone and warfarin and risk of oesophageal cancer: A case-control study

Chris Cardwell; Ronald Mc Dowell; Carmel/ Hughes; John Busby; Peter Murchie

doi:10.1016/j.canep.2024.102552

Oral prednisolone and warfarin and risk of oesophageal cancer: A case-control study

Chris Cardwell
, Ronald Mc Dowell
, Carmel/ Hughes
, John Busby
, Peter Murchie

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
A recent epidemiological study systematically screened 250 prescription medications for associations with oesophageal cancer risk, using Scottish data, and identified an increased risk with use of prednisolone and warfarin. We investigated whether oral prednisolone or warfarin use was associated with increased oesophageal cancer risk.
Methods
A case-control study was conducted within the Clinical Practice Research Datalink. In the primary analysis oesophageal cancer cases were identified from linked cancer registry records. Up to 5 cancer-free controls were matched to each case (based upon sex, birth year, GP practice and year of GP registration). Prednisolone and warfarin medications were identified from prescribing records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression after adjusting for covariates including demographics, comorbidities and medication use.
Results
There were 4,552 oesophageal cancer cases and 22,601 matched control participants. Overall, there was no evidence of an increased risk of oesophageal cancer risk with oral prednisolone use (unadjusted OR=1.16 95% CI 1.06, 1.27 and adjusted OR=0.99 95% CI 0.89, 1.11) or warfarin use (unadjusted OR=1.12 95% CI 0.99, 1.28 and adjusted OR=1.08 95% CI 0.92, 1.27).
Conclusions
In this large population-based study, oral prednisolone and warfarin were not associated with oesophageal cancer risk.

Original language	English
Article number	102552
Pages (from-to)	1-7
Number of pages	8
Journal	Cancer Epidemiology
Volume	90
Early online date	6 Mar 2024
DOIs	https://doi.org/10.1016/j.canep.2024.102552
Publication status	Published (in print/issue) - 30 Jun 2024

Bibliographical note

Data Availability Statement

The data used in this study were obtained under licence from the Clinical Practice Research Datalink (CPRD). The licence agreement does not allow data sharing.

Funding

This work was supported by Cancer Research UK (reference C37316/A25535). The sponsors had no involvement with the planning, execution, or completion of the study. This study is based in part on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The data is provided by patients and collected by the NHS as part of their care and support. The National Cancer Registration Dataset Copyright © (2020) was re-used with the permission of The Health & Social Care Information Centre. All rights reserved. The interpretation and conclusions contained in this study are those of the author/s alone. The data used in this study were obtained under licence from the Clinical Practice Research Datalink (CPRD). The licence agreement does not allow data sharing. This work was supported by Cancer Research UK (reference C37316/A25535 ). The sponsors had no involvement with the planning, execution, or completion of the study. This study is based in part on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The data is provided by patients and collected by the NHS as part of their care and support. The National Cancer Registration Dataset Copyright © (2020) was re-used with the permission of The Health & Social Care Information Centre. All rights reserved. The interpretation and conclusions contained in this study are those of the author/s alone.

Funders	Funder number
Cancer Research UK	C37316/A25535

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Corticosteroids
Oesophageal cancer
Epidemiology
Prednisolone
Warfarin

Access to Document

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1-s2.0-S1877782124000316-mainFinal published version, 399 KBLicence: CC BY

Cite this

@article{a829ab76298f45c996d44f577b5a69d6,

title = "Oral prednisolone and warfarin and risk of oesophageal cancer: A case-control study",

abstract = "Background A recent epidemiological study systematically screened 250 prescription medications for associations with oesophageal cancer risk, using Scottish data, and identified an increased risk with use of prednisolone and warfarin. We investigated whether oral prednisolone or warfarin use was associated with increased oesophageal cancer risk. Methods A case-control study was conducted within the Clinical Practice Research Datalink. In the primary analysis oesophageal cancer cases were identified from linked cancer registry records. Up to 5 cancer-free controls were matched to each case (based upon sex, birth year, GP practice and year of GP registration). Prednisolone and warfarin medications were identified from prescribing records. Odds ratios (OR) and 95\% confidence intervals (CI) were calculated using conditional logistic regression after adjusting for covariates including demographics, comorbidities and medication use. Results There were 4,552 oesophageal cancer cases and 22,601 matched control participants. Overall, there was no evidence of an increased risk of oesophageal cancer risk with oral prednisolone use (unadjusted OR=1.16 95\% CI 1.06, 1.27 and adjusted OR=0.99 95\% CI 0.89, 1.11) or warfarin use (unadjusted OR=1.12 95\% CI 0.99, 1.28 and adjusted OR=1.08 95\% CI 0.92, 1.27). Conclusions In this large population-based study, oral prednisolone and warfarin were not associated with oesophageal cancer risk. ",

keywords = "Corticosteroids, Oesophageal cancer, Epidemiology, Prednisolone, Warfarin",

author = "Chris Cardwell and \{Mc Dowell\}, Ronald and Carmel/ Hughes and John Busby and Peter Murchie",

year = "2024",

month = jun,

day = "30",

doi = "10.1016/j.canep.2024.102552",

language = "English",

volume = "90",

pages = "1--7",

journal = "Cancer Epidemiology",

issn = "1877-7821",

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TY - JOUR

T1 - Oral prednisolone and warfarin and risk of oesophageal cancer: A case-control study

AU - Cardwell, Chris

AU - Mc Dowell, Ronald

AU - Hughes, Carmel/

AU - Busby, John

AU - Murchie, Peter

PY - 2024/6/30

Y1 - 2024/6/30

N2 - Background A recent epidemiological study systematically screened 250 prescription medications for associations with oesophageal cancer risk, using Scottish data, and identified an increased risk with use of prednisolone and warfarin. We investigated whether oral prednisolone or warfarin use was associated with increased oesophageal cancer risk. Methods A case-control study was conducted within the Clinical Practice Research Datalink. In the primary analysis oesophageal cancer cases were identified from linked cancer registry records. Up to 5 cancer-free controls were matched to each case (based upon sex, birth year, GP practice and year of GP registration). Prednisolone and warfarin medications were identified from prescribing records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression after adjusting for covariates including demographics, comorbidities and medication use. Results There were 4,552 oesophageal cancer cases and 22,601 matched control participants. Overall, there was no evidence of an increased risk of oesophageal cancer risk with oral prednisolone use (unadjusted OR=1.16 95% CI 1.06, 1.27 and adjusted OR=0.99 95% CI 0.89, 1.11) or warfarin use (unadjusted OR=1.12 95% CI 0.99, 1.28 and adjusted OR=1.08 95% CI 0.92, 1.27). Conclusions In this large population-based study, oral prednisolone and warfarin were not associated with oesophageal cancer risk.

AB - Background A recent epidemiological study systematically screened 250 prescription medications for associations with oesophageal cancer risk, using Scottish data, and identified an increased risk with use of prednisolone and warfarin. We investigated whether oral prednisolone or warfarin use was associated with increased oesophageal cancer risk. Methods A case-control study was conducted within the Clinical Practice Research Datalink. In the primary analysis oesophageal cancer cases were identified from linked cancer registry records. Up to 5 cancer-free controls were matched to each case (based upon sex, birth year, GP practice and year of GP registration). Prednisolone and warfarin medications were identified from prescribing records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression after adjusting for covariates including demographics, comorbidities and medication use. Results There were 4,552 oesophageal cancer cases and 22,601 matched control participants. Overall, there was no evidence of an increased risk of oesophageal cancer risk with oral prednisolone use (unadjusted OR=1.16 95% CI 1.06, 1.27 and adjusted OR=0.99 95% CI 0.89, 1.11) or warfarin use (unadjusted OR=1.12 95% CI 0.99, 1.28 and adjusted OR=1.08 95% CI 0.92, 1.27). Conclusions In this large population-based study, oral prednisolone and warfarin were not associated with oesophageal cancer risk.

KW - Corticosteroids

KW - Oesophageal cancer

KW - Epidemiology

KW - Prednisolone

KW - Warfarin

UR - https://www.scopus.com/pages/publications/85186976424

U2 - 10.1016/j.canep.2024.102552

DO - 10.1016/j.canep.2024.102552

M3 - Article

C2 - 38447250

SN - 1877-7821

VL - 90

SP - 1

EP - 7

JO - Cancer Epidemiology

JF - Cancer Epidemiology

M1 - 102552

ER -

Oral prednisolone and warfarin and risk of oesophageal cancer: A case-control study

Abstract

Bibliographical note

Data Availability Statement

Funding

UN SDGs

Keywords

Access to Document

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