Cancer mortality does not differ by antiarrhythmic drug use : A population-based cohort of Finnish men

In-vitro studies have suggested that the antiarrhythmic drug digoxin might restrain the growth of cancer cells by inhibiting Na+/K+-ATPase. We evaluated the association between cancer mortality and digoxin, sotalol and general antiarrhythmic drug use in a retrospective cohort study. The study population consists of 78,615 men originally identified for the Finnish Randomized Study of Screening for Prostate Cancer. Information on antiarrhythmic drug purchases was collected from the national prescription database. We used the Cox regression method to analyze separately overall cancer mortality and mortality from the most common types of cancer. During the median follow-up of 17.0 years after the baseline 28,936 (36.8%) men died, of these 8,889 due to cancer. 9,023 men (11.5%) had used antiarrhythmic drugs. Overall cancer mortality was elevated among antiarrhythmic drug users compared to non-users (HR 1.43, 95% CI 1.34-1.53). Similar results were observed separately for digoxin and for sotalol. However, the risk associations disappeared in long-term use and were modified by background co-morbidities. All in all, cancer mortality was elevated among antiarrhythmic drug users. This association is probably non-causal as it was related to short-term use and disappeared in long-term use. Our results do not support the anticancer effects of digoxin or any other antiarrhythmic drug.Peer reviewe

Blood cholesterol, tumor clinical characteristics and risk of prostate cancer progression after radical prostatectomy

BACKGROUND: The effects of blood cholesterol levels on prostate cancer prognosis are unclear. We explored the associations between blood cholesterol levels and prostate cancer clinical characteristics including Gleason score and TNM-stage, as well as risk of prostate cancer recurrence and death after radical prostatectomy. The association between statin-induced cholesterol decline and prostate cancer prognosis was also studied. METHODS: The study cohort consisted of 1,314 prostate cancer patients who underwent radical prostatectomy as primary management at the Tampere University Hospital between 1995 and 2009. The follow-up continued until the end of 2016. RESULTS: No associations between cholesterol and prostate cancer severity were found. HDL over 1 mmol/l and LDL over 3 mmol/l were associated with reduced risk of all-cause death in time-dependent analysis. However, the risk association was short-term as neither HDL or LDL measured three years earlier had an effect on prostate cancer prognosis. Modest statin-induced cholesterol decline lowered the risk of prostate cancer recurrence. HRs by modest total cholesterol and LDL declines were 0.24 (0.09-0.60) and 0.31 (0.11-0.88) respectively. CONCLUSIONS: Our findings do not support cholesterol as a risk factor for prostate cancer severity or prognosis after prostatectomy. Cholesterol decline by statin treatment was associated with improved recurrence-free survival compared to statin users whose cholesterol did not decline, which supports importance of controlling for compliance to statin use when estimating effects of statins in prostate cancer