NDLI: The Association Between Vitamin K Antagonist Therapy and Site-specific Cancer Incidence Estimated by Using Heart Valve Replacement as an Instrumental Variable

Content Provider	PubMed Central
Author	Ahern, Thomas P. Pedersen, Lars Claus, Sværke Rothman, Kenneth J. Sørensen, Henrik Toft Lash, Timothy L.
Copyright Year	2011
Abstract	Earlier studies suggest a protective association between vitamin K antagonist (VKA) anticoagulants and the incidence of cancer. The authors examined the associations between VKA therapy and incidence of 24 site-specific cancers with a Danish population-based cohort study, using heart valve replacement as an instrumental variable. The authors enrolled 9,727 Danish residents who received a replacement heart valve between 1989 and 2006. The heart valve recipients were matched with 95,481 unexposed individuals on age and sex. The authors used the heart valve replacement instrument to estimate rate ratios associating VKA therapy with incidence of the 24 site-specific cancers using Poisson regression models. Direct associations between VKA therapy and incidence of the 24 cancers were estimated in a prescription validation subset. The instrumental variable associations were plotted according to the inverse normal of rank percentile and subjected to semi-Bayes shrinkage adjustment for multiple comparisons. The pattern of associations was consistent with a null-centered Gaussian distribution. No individual cancer site showed a substantial positive or negative association with VKA therapy in the prescription validation subset, the instrumental variable analysis, or the analysis with semi-Bayes adjustment. These results do not support the existing hypothesis that VKA therapy is associated with reduced cancer risk.
Related Links	http://dx.doi.org/10.1093/aje/kwr268
Ending Page	1390
Page Count	9
Starting Page	1382
File Format	PDF
ISSN	00029262
e-ISSN	14766256
Journal	American Journal of Epidemiology
Issue Number	12
Volume Number	174
Language	English
Publisher	Oxford University Press
Publisher Date	2011-12-15
Access Restriction	Open
Rights Holder	Oxford University Press
Subject Keyword	Epidemiology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Epidemiology

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