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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Null Results in Brief

Associations of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use with Colorectal Cancer Risk in the Women's Health Initiative

Theodore M. Brasky, Katrina F. Flores, Joseph C. Larson, Alison M. Newton, Aladdin H. Shadyab, Jonathan H. Watanabe, Dorothy S. Lane, Cynthia A. Thomson and Andrea Z. LaCroix
Theodore M. Brasky
1Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio.
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  • For correspondence: theodore.brasky@osumc.edu
Katrina F. Flores
2Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California.
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Joseph C. Larson
3Women's Health Initiative, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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Alison M. Newton
1Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio.
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Aladdin H. Shadyab
2Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California.
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Jonathan H. Watanabe
4Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, Irvine, California.
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Dorothy S. Lane
5Department of Family, Population and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York.
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Cynthia A. Thomson
6The University of Arizona Cancer Center, Tucson, Arizona.
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Andrea Z. LaCroix
2Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California.
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DOI: 10.1158/1055-9965.EPI-20-1401
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Abstract

Background: Use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) has been postulated to reduce cancer risk by inhibition of tumor progression, vascularization, and metastasis. The renin–angiotensin system is upregulated in colorectal cancers; however, the association of ACEi and ARB use with colorectal cancer risk is not well understood.

Methods: The study population was 142,812 Women's Health Initiative participants free of colorectal cancer who reported on ACEi and ARB use at baseline; 2,216 incident colorectal cancers were diagnosed during 10 years of follow-up. Cox regression models estimated adjusted HRs and 95% confidence intervals for associations relative to nonuse among normotensive women, untreated hypertensive women, and hypertensive women treated with other antihypertensive medications.

Results: HRs among women who used any ACEi or ARB compared with nonuse in the three referent groups ranged between 0.97 and 1.01. Findings were similar for increased ACEi/ARB duration and for medications examined as separate classes or individually.

Conclusions: In this large prospective study of women, no associations of ACEi or ARB use with colorectal cancer risk were observed.

Impact: Choice of drug in the large population of aging women who will be prescribed ACEi and ARB should be made without factoring in any benefit on colorectal cancer risk.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2021;XX:XX–XX

  • Received September 24, 2020.
  • Revision received November 16, 2020.
  • Accepted February 9, 2021.
  • Published first February 24, 2021.
  • ©2021 American Association for Cancer Research.
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This OnlineFirst version was published on March 31, 2021
doi: 10.1158/1055-9965.EPI-20-1401

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Associations of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use with Colorectal Cancer Risk in the Women's Health Initiative
Theodore M. Brasky, Katrina F. Flores, Joseph C. Larson, Alison M. Newton, Aladdin H. Shadyab, Jonathan H. Watanabe, Dorothy S. Lane, Cynthia A. Thomson and Andrea Z. LaCroix
Cancer Epidemiol Biomarkers Prev March 31 2021 DOI: 10.1158/1055-9965.EPI-20-1401

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Associations of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use with Colorectal Cancer Risk in the Women's Health Initiative
Theodore M. Brasky, Katrina F. Flores, Joseph C. Larson, Alison M. Newton, Aladdin H. Shadyab, Jonathan H. Watanabe, Dorothy S. Lane, Cynthia A. Thomson and Andrea Z. LaCroix
Cancer Epidemiol Biomarkers Prev March 31 2021 DOI: 10.1158/1055-9965.EPI-20-1401
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