Beta‐blockers and epithelial ovarian cancer survival: A Norwegian population‐based cohort study

Abstract Cancer diagnosis and therapy cause stress to the body. Preclinical studies have shown that stress hormones can stimulate tumor progression and metastasis by interacting with β‐adrenergic receptors, and that β‐blockers can inhibit those processes. We assessed if β‐blocker use was associated with survival in a nationwide cohort of women with epithelial ovarian cancer (EOC). We identified all women aged ≥40 years who underwent EOC surgery in 2004–2018 in Norway through the Cancer Registry of Norway. We estimated the association between peri‐diagnostic and post‐diagnostic β‐blocker use and survival. We used Cox models, adjusted for sociodemographic and health factors, and reported hazard ratios (HRs) and 95% confidence intervals (CIs). The difference in overall survival time between β‐blocker users and non‐users was estimated as the difference in restricted mean survival time at 5 years after diagnosis using flexible parametric models. We included 3911 women with EOC; 540 (14%) used β‐blockers at diagnosis, 1672 (43%) died of the disease, and 1882 (48%) died overall. We found an association between peri‐diagnostic β‐blocker use and longer EOC‐specific survival (HR = 0.85, 95%CI 0.73–1.00; p‐value = 0.048), and an indication of an association with overall survival (HR = 0.89, 95%CI 0.77–1.02; p‐value = 0.101). Analysis of post‐diagnostic β‐blocker use, which included only women who survived 12 months or longer ( n = 3344), found similar associations. At 5 years from diagnosis, peri‐diagnostic β‐blocker users lived on average 1.28 months longer than non‐users (95%CI 0.01–2.60 months). The results support the hypothesis that β‐blocker use improves EOC‐specific survival in women with EOC.