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Relationship between tamoxifen and cataracts: a nationwide cohort study of women in South Korea

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Although prospective randomized clinical trials have reported that the use of prophylactic tamoxifen in patients at a high risk of breast cancer is associated with an increased risk of cataracts development, such findings are inconsistent. This study aimed to clarify the relationship between adjuvant tamoxifen use and cataracts risk using a nationwide longitudinal population-based registry.

Methods

This retrospective cohort study was conducted using the Korean National Health Insurance claims database over a 15-year period (January 2007–December 2021). Data from all female patients diagnosed with ductal carcinoma in situ (DCIS) between 2009 and 2015 were extracted. We evaluated the incidence of cataracts diagnosis and surgery after adjuvant tamoxifen administration in patients with DCIS.

Results

A total of 43,434 patients who met the inclusion criteria were diagnosed with DCIS between 2009 and 2015. Data from 2849 patients receiving tamoxifen and 1615 patients not receiving tamoxifen were analyzed before matching. After matching for comorbidities, type of breast surgery, and age, both groups consisted of 1597 patients. Both before and after matching, adjuvant tamoxifen was not a significant factor for an increased risk of cataracts diagnosis alone or with surgery.

Conclusion

Our study showed that adjuvant tamoxifen was not a risk factor for increased cataracts diagnosis and surgery in patients with DCIS. This finding provides a basis for physicians to reduce their ocular toxicity concerns regarding the risk of patients developing cataracts by tamoxifen treatment.

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Data availability

All data generated or analyzed during this study are included in this research article and the supplementary information files. However, the original data are prohibited from being exported outside due to NHI policy.

Abbreviations

DCIS:

Ductal carcinoma in situ

NSABP:

National surgical adjuvant breast and bowel project

OR:

Odds ratio

CI:

Confidence interval

NHI:

National health insurance

HIRA:

Health insurance review and assessment service

ICD-10:

International classification of disease 10th revision

IRB:

Institutional review board

HR:

Hazard ratio

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Acknowledgements

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, College of Medicine, Seoul St Mary’s Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea

    Chang Ik Yoon, Dooreh Kim & Woo-Chan Park

  2. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hye Sun Lee & Soyoung Jeon

Authors
  1. Chang Ik Yoon
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  2. Hye Sun Lee
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Contributions

CY and WP had full access to all of the data in the study and they take responsibility for the integrity of the data and accuracy of the data analysis. Conceptualization: CY; Data curation: HL and SJ; Funding acquisition and Investigation: DK, HL, SJ, and CY; Methodology: DK, HL, SJ, and CY; Resources: HL and SJ; Formal analysis: CY; Supervision: WP; Writing—original draft: CY.

Corresponding author

Correspondence to Woo-Chan Park.

Ethics declarations

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The protocol was approved by the Institutional Review Board (Local IRB Number: KC22ZISI0340) of Seoul St Mary’s Hospital. The need for informed consent was waived by the IRB due to the retrospective study design.

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Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 42 KB)

Patients flow diagram of study design (cataract diagnosis + cataract surgery). Supplementary file2 (TIF 797 KB)

10549_2022_6765_MOESM3_ESM.tif

Cumulative incidence of cataract according to tamoxifen use in DCIS patients: cataract diagnosis only a before matching, b after matching, cataract diagnosis + cataract surgery c before matching, d after matching. Supplementary file3 (TIF 944 KB)

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Yoon, C.I., Lee, H.S., Jeon, S. et al. Relationship between tamoxifen and cataracts: a nationwide cohort study of women in South Korea. Breast Cancer Res Treat 197, 603–612 (2023). https://doi.org/10.1007/s10549-022-06765-3

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  • DOI: https://doi.org/10.1007/s10549-022-06765-3

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