eprintid: 10105353
rev_number: 20
eprint_status: archive
userid: 608
dir: disk0/10/10/53/53
datestamp: 2020-07-20 09:31:11
lastmod: 2021-10-07 22:01:06
status_changed: 2020-07-20 09:31:11
type: article
metadata_visibility: show
creators_name: Cheung, KS
creators_name: Chan, EW
creators_name: Seto, WK
creators_name: Wong, ICK
creators_name: Leung, WK
title: ACE (Angiotensin-Converting Enzyme) Inhibitors/Angiotensin Receptor Blockers Are Associated With Lower Colorectal Cancer Risk: A Territory-Wide Study With Propensity Score Analysis
ispublished: pub
divisions: UCL
divisions: B02
divisions: C08
divisions: D10
divisions: G11
keywords: angiotensin-converting enzyme inhibitors, colonoscopy, inflammatory bowel disease, propensity score, renin
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
abstract: Whether ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers modify colorectal cancer risk remains controversial. We aimed to determine association between their use and colorectal cancer risk after a negative baseline colonoscopy. This is a territory-wide retrospective cohort study recruiting patients aged ≥40 who had undergone colonoscopy between 2005 and 2013. Exclusion criteria included colorectal cancer detected <6 months of index colonoscopy, prior colorectal cancer, inflammatory bowel disease, and prior colectomy. The primary outcome was colorectal cancer diagnosed between 6 and 36 months after index colonoscopy. Sites of colorectal cancer were categorized as proximal (proximal to splenic flexure) and distal cancer. The adjusted hazard ratio of colorectal cancer with ACE inhibitor/angiotensin receptor blocker use (≥180-day use within 5 years before index colonoscopy) was derived by propensity score regression adjustment of 23 covariates (including patient's factors, concurrent medication use, and endoscopy center's performance). Of 187 897 eligible patients, 30 856 (16.4%) were ACE inhibitors/angiotensin receptor blocker users. Eight hundred fifty-four (0.45%) developed colorectal cancer between 6 and 36 months after index colonoscopy (proximal cancer: 147 [17.2%]). These drugs were associated with lower risk of colorectal cancer that developed <3 years after index colonoscopy (adjusted hazard ratio, 0.78 [95% CI, 0.64-0.96]), but not colorectal cancer that developed >3years (adjusted hazard ratio, 1.18 [95% CI, 0.88-1.57]); every single year increase in the drug use was associated with 5% reduction in adjusted hazard ratio risk. ACE inhibitors/angiotensin receptor blocker were associated with a lower colorectal cancer risk in a duration-response manner.
date: 2020-09
date_type: published
official_url: https://doi.org/10.1161/HYPERTENSIONAHA.120.15317
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1796286
doi: 10.1161/HYPERTENSIONAHA.120.15317
lyricists_name: Wong, Ian
lyricists_id: ICKWO00
actors_name: Harris, Jean
actors_id: JAHAR68
actors_role: owner
full_text_status: public
publication: Hypertension
volume: 76
number: 3
pagerange: 968-975
event_location: United States
citation:        Cheung, KS;    Chan, EW;    Seto, WK;    Wong, ICK;    Leung, WK;      (2020)    ACE (Angiotensin-Converting Enzyme) Inhibitors/Angiotensin Receptor Blockers Are Associated With Lower Colorectal Cancer Risk: A Territory-Wide Study With Propensity Score Analysis.                   Hypertension , 76  (3)   pp. 968-975.    10.1161/HYPERTENSIONAHA.120.15317 <https://doi.org/10.1161/HYPERTENSIONAHA.120.15317>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10105353/3/Wong_ACE%20%28Angiotensin-Converting%20Enzyme%29%20Inhibitors%3AAngiotensin%20Receptor%20Blockers%20Are%20Associated%20With%20Lower%20Colorectal%20Cancer%20Risk_AAM.pdf