Calcium Channel Blockers and the Risk for Lung Cancer: A Population-Based Nested Case-Control Study

Background: Calcium channels are involved in the regulation of processes governing cell proliferation and apoptosis. It has been suggested that calcium channel blockers (CCBs) may increase the risk of lung cancer, however current evidence is conflicting and limited.

Objective: To investigate the associations between CCBs use and lung cancer.

Methods: We conducted a population-based nested case-control study. A cohort was formed of patients prescribed their first antihypertensive agent between 2000 to 2014. CCBs exposure was obtained by identification of all prescriptions dispensed during study follow-up.

Cases were patients newly-diagnosed with lung cancer during follow-up. Each case was matched with 10 controls by age, sex, calendar year of cohort entry, and duration of follow-up to each case. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) of lung cancer associated with ever use of CCBs.

Results: During a median follow-up of 6.2 years, we identified 4,174 cases of lung cancer. Ever use of CCBs was associated with an increased risk of lung cancer (adjusted OR 1.13; 95% CI 1.06-1.21), when compared with the use of other antihypertensive drugs. A duration-response relation was observed, with the ORs gradually increasing with longer cumulative duration of CCB use (< 5 years, OR 1.12, 95% CI 1.04-1.20; 5-10 years, OR 1.22, 95% CI 1.07-1.40; >10 years, OR 1.33, 95% CI 0.90-1.96; p-trend < 0.001).

Conclusions: The results of this large population-based study indicate that the use of CCBs is associated with a modest but significant increase in the risk of lung cancer. This association appeared to increase with longer duration of use.