Long-Term Vitamin K Antagonists and Cancer Risk: A Systematic Review and Meta-Analysis

American Journal of Clinical Oncology
Mohammed ShurrabDennis T Ko


Vitamin K antagonists (VKAs) remain one of the most commonly used anticoagulation therapies. The potential anticancer effect of long-term use of VKAs has been a matter of debate with conflicting results. Our goal was to perform a systematic review and meta-analysis examining the association between long-term VKAs use and cancer risk. Systematic searches of multiple major databases were performed from inception until January 2018. We included studies of adults that compared incidence of any cancer between ≥6 months use of VKAs (long-term group) and <6 months use of VKAs or nonuse (control group). Primary outcome was all-cancer incidence and secondary outcomes were cancer-specific incidence, all-cause death and cancer-specific mortality. Hazard ratios (HRs) were pooled using a random-effects model, and individual studies were weighted using inverse variance. We identified 9 observational studies that included 1,521,408 patients. No randomized trials were identified. In comparison to control, long-term use of VKAs was associated with a significant reduction in incidence of all cancers (HR, 0.84; 95% confidence interval [CI], 0.81-0.88; P<0.001). In a prespecified subgroup analysis, long-term use of VKAs demonstrated a significant ...Continue Reading


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Related Concepts

Indirect Thrombin Inhibitors
Malignant Neoplasms
Vitamin K
Anticoagulation Therapy
Cessation of Life
Clinical Trials, Randomized
Meta Analysis (Statistical Procedure)
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