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

source extracted confidence: high 2026-04-09
#anticoagulants #canada #humans #incidence #neoplasms

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

Shurrab et al., 2019 | Am J Clin Oncol | Meta Analysis

Citation

Shurrab Mohammed, Quinn Kieran L, ... Ko Dennis T. Long-Term Vitamin K Antagonists and Cancer Risk: A Systematic Review and Meta-Analysis. Am J Clin Oncol. 2019-Sep;42(9):717-724. doi:10.1097/COC.0000000000000571

Abstract

OBJECTIVES: 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. METHODS: 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. RESULTS: 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 reduction in all-cancer incidence when compared with control in individuals whose indication for VKAs were venous thromboembolism (HR, 0.69; 95% CI, 0.52-0.90; P=0.007). CONCLUSIONS: The use of long-term VKAs, for any indication, is associated with lower cancer incidence. This finding could have important clinical implications for the choice of oral anticoagulation therapies among specific patients with a higher baseline risk of cancer.

Key Findings

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 reduction in all-cancer incidence when compared with control in individuals whose indication for VKAs were venous thromboe

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population a higher baseline risk
Sample Size 1521408
Age Range See abstract
Condition See abstract

MeSH Terms

  • Anticoagulants
  • Canada
  • Humans
  • Incidence
  • Neoplasms
  • Prognosis
  • Risk Factors
  • Vitamin K

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: vitamin-k

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09