Cardiovascular medications and survival in people with ovarian cancer: A population-based cohort study from British Columbia, Canada

• Published in: Gynecologic oncology Vol. 162; no. 2; pp. 461 - 468
• Main Authors: Hanley, Gillian E., Kaur, Paramdeep, Berchuck, Andrew, Chase, Anne, Grout, Bronwyn, Deurloo, Cindy McKinnon, Pike, Malcolm, Richardson, Jean, Terry, Kathryn L., Webb, Penelope M., Pearce, C. Leigh
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2021
• Subjects: Administrative Claims, Healthcare - statistics & numerical data; Adrenergic beta-Antagonists - therapeutic use; Aged; Beta-blockers; British Columbia - epidemiology; Carcinoma, Ovarian Epithelial - diagnosis; Carcinoma, Ovarian Epithelial - mortality; Carcinoma, Ovarian Epithelial - therapy; Cardiovascular Diseases - drug therapy; Drug Prescriptions - statistics & numerical data; Female; Follow-Up Studies; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Middle Aged; Ovarian cancer; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - mortality; Ovarian Neoplasms - therapy; Retrospective Studies; Statins; Survival; Survival Analysis; British Columbia; Beta-blockers; Survival; Statins; Ovarian cancer
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2021.05.021

Research examining survival among people with ovarian cancer following use of statins or β-blockers has been conflicting. Many studies to date have suffered from immortal time bias and/or had limited power. To address these limitations, we used time-dependent analyses to study the association between statin or β-blocker use among all people diagnosed with an epithelial ovarian cancer in British Columbia, Canada between 1997 and 2015. Population-based administrative data were linked for 4207 people with ovarian cancer. Statin or β-blocker use was examined using time-dependent variables for any use, cumulative duration of use and by user-group according to whether use was initiated before or after their ovarian cancer diagnosis. Cox proportional hazards models were run to estimate the association between statin or β-blocker use and survival. Any postdiagnosis use of statins was associated with better ovarian cancer survival in the full cohort (adjusted hazard ratio (aHR) = 0.76, 95% CI 0.64, 0.89) and among women with serous cancers (aHR = 0.80, 95%CI 0.67–0.96). This was primarily driven by new use post-diagnosis (aHR = 0.67, 95%CI, 0.51-0.89), but there was a trend towards better survival among those who continued use from before diagnosis (aHR 0.83, 95%CI, 0.68-1.00). There was no statistically significant association between β-blocker use and survival. Postdiagnosis statin use was associated with improved survival among people with ovarian cancer. Given the consistency of this finding in the literature, we recommend a randomized clinical trial of statin use in people with ovarian cancer. •Postdiagnosis use of statins was associated with better ovarian cancer survival.•There was no statistically significant association between β-blocker use and survival.•There was no difference between hydrophilic and lipophilic statins.•We recommend a clinical trial of statin use among people with ovarian cancer.