A population-based case-control study on the association of Angelica sinensis exposure with risk of breast cancer

Jhong-Yuan Chen; Yi-Hsiu Wang; Atik Choirul Hidajah; Chung-Yi Li

doi:10.1016/j.jtcme.2019.10.003

A population-based case-control study on the association of Angelica sinensis exposure with risk of breast cancer

J Tradit Complement Med. 2019 Oct 23;10(5):454-459. doi: 10.1016/j.jtcme.2019.10.003. eCollection 2020 Sep.

Authors

Jhong-Yuan Chen^{1

2}, Yi-Hsiu Wang¹, Atik Choirul Hidajah³, Chung-Yi Li^{2

3

4}

Affiliations

¹ Department of Traditional Chinese Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, Taiwan.
² Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, East District, Tainan, Taiwan.
³ Department of Epidemiology, Faculty of Public Health, Universitas Airlangga, Kampus C UNAIR, Jl. Mulyorejo Surabaya, East Java, Indonesia.
⁴ Department of Public Health, College of Public Health, China Medical University, No.91, Xueshi Road, North District, Taichung, Taiwan.

Abstract

Background: Due to a lack of evidence from large-scale epidemiological studies by far on this issue, whether there is a link between Angelica sinensis exposure and breast cancer risk remained inconclusive.

Methods: We conducted a population-based case-control study using Taiwan's National Health Insurance claim data, in which all breast cancer patients newly diagnosed between 2005 and 2008 were employed as the case group (n = 34,262) and a random sample of non-breast cancer individuals selected from 1-million beneficiaries registered in 2005 was served as the control group. For fair comparability, we employed the time density sampling method to select controls who were matched to case on date of breast cancer diagnosis and age with a case/control ratio of 1/3 (n = 102,786).

Results: We found that the use of Angelica sinensis presents a weakly but significantly protective effect on breast cancer (adjusted odds ratio (aOR) 0.95, 95% confidence interval (CI) 0.93-0.98), with a significant dose-gradient relationship. We also noted a stronger association with breast cancer with initial use of Angelica sinensis at a longer time before breast cancer diagnosis, and found that the seemingly protective effect of Angelica sinensis was more obvious among women who had initial use at 47-55 years (aOR 0.93, 95% CI 0.88-0.98).

Conclusion: This population-based case-control study revealed that exposure to Angelica sinensis showed a weakly but significantly protective effect on breast cancer risk, which could ease people's concern over the potential carcinogenic effect from exposure to Angelica sinensis.

Keywords: Angelica sinensis; Breast cancer; CI, confidence interval; Herbal medicine; ICD-9-CM, International Classification of Disease 9th version Clinical Modification; NHIRD, national health insurance research database; OR, odds ratio; Phytomedicine; TCM, traditional Chinese medicine; Traditional Chinese medicine; aOR, adjusted odds ratio.