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Digitalis Use and the Risk of Breast Cancer: A Systematic Review and Meta-Analysis

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Abstract

Introduction

Previous epidemiological studies have indicated an increased risk of breast cancer associated with digitalis medication, though results are inconsistent. We performed this systematic review of available epidemiological studies to clarify the association between digitalis use and the risk of breast cancer.

Methods

A search of studies published through May 2016 in MEDLINE and EMBASE databases was performed, supplemented by manual searches of reference lists. The quality of the included studies was assessed, and relative risks were pooled using both random- and fixed-effect models.

Results

Three case–control studies and six cohort studies were identified. Meta-analysis generated a pooled relative risk of 1.35 (95% confidence interval 1.24–1.46) in both fixed- and random-effect models. The heterogeneity test suggested low heterogeneity across studies. The funnel plot suggested no existence of publication bias. Subgroup analysis by study design revealed an increased risk of breast cancer associated with digitalis use from cohort studies only (relative risk = 1.39, 95% confidence interval 1.27–1.52), rather than from case–control studies. Studies with adjustment for tobacco smoking or body mass index generated lower overall estimates than those not adjusted.

Conclusions

Existing epidemiological evidence regarding the association between digitalis use and the risk of breast cancer remains inconclusive and more well-designed studies are still needed.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Chen Zhang

  2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

    Shao-Hua Xie

  3. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China

    Bingfei Xu & Pian Liu

  4. Department of Obsterics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Shi Lu

Authors
  1. Chen Zhang
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  2. Shao-Hua Xie
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  3. Bingfei Xu
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  4. Shi Lu
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  5. Pian Liu
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Corresponding author

Correspondence to Pian Liu.

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Funding

This study was supported by the Fundamental Research Funds for the Central Universities, and the Natural Science Foundation of China (Nos. 81402198, 81500498).

Conflict of interest

Chen Zhang, Shao-Hua Xie, Bingfei Xu, Shi Lu, and Pian Liu have no conflicts of interest that are directly relevant to the content of this study.

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Zhang, C., Xie, SH., Xu, B. et al. Digitalis Use and the Risk of Breast Cancer: A Systematic Review and Meta-Analysis. Drug Saf 40, 285–292 (2017). https://doi.org/10.1007/s40264-016-0484-z

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  • DOI: https://doi.org/10.1007/s40264-016-0484-z

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