Key result
Beta-blocker initiation after first colorectal polyp is linked to ~13% lower 10-year CRC risk.
Why the study?
Beta-blockers treat hemangioma and may decrease cancer cell proliferation, prompting the hypothesis that individuals with colorectal polyps may benefit from beta-blocker initiation.
Does beta-blocker initiation reduce incident CRC and CRC mortality in individuals diagnosed with their first colorectal polyp?
Cohort (n=30,399)
Yes
Does beta-blocker initiation reduce incident CRC and CRC mortality in individuals diagnosed with their first colorectal polyp?
Beta-blocker initiation within 2 years of colorectal polyp diagnosis is associated with lower CRC incidence and, in women, lower CRC mortality.
Answers are grounded in this paper and cite their sources.
Should not yet change post-polyp management; leaves open a chemopreventive role pending randomized trials.
BACKGROUND AND AIMS: Beta-blockers are successfully used to treat hemangioma and may decrease the proliferation of cancer cells. We hypothesized that individuals with colorectal polyps may also benefit from beta-blocker initiation. METHODS: Individuals diagnosed with their first colorectal polyp 2006-2016 in the nationwide Swedish ESPRESSO histopathology cohort aged 45-79 years without CRC were eligible. We excluded individuals with previous indications for beta-blocker (cerebrovascular disease, heart failure, aortic aneurysms, myocardial infarction) and individuals with contraindications for preventive beta-blocker initiation (COPD, dementia, liver cirrhosis, Charlson score > 5 or metastatic cancer). Using duplication and inverse probability weighting, we emulated a target trial of beta-blocker initiation within 2 years of the first polyp diagnosis. Main outcomes were incident CRC, CRC mortality, and all-cause mortality until 2019. RESULTS: In total, 30,399 individuals met our inclusion criteria and were followed for a median of 8 years. Beta-blockers were initiated in 2083 (6.9%) eligible individuals. The 10-year cumulative incidence in initiators versus non-initiators was 5.8% versus 8.6% for CRC incidence, 0.9% versus 1.1% for CRC mortality. The corresponding fully adjusted hazard ratios (HRs) were 0.87 (95% confidence interval, 95% CI: 0.85-0.89) and 0.96 (0.83-1.09). CRC mortality was significantly reduced in women HR 0.78 (0.68-0.99) but not in men HR = 1.14 (0.80-4.46). Cumulative CRC mortality was 0.6% in initiating women versus. 1.1% in non-initiating women. CONCLUSION: Beta-blocker initiation within 2 years of polyp diagnosis was linked to a lower CRC incidence for all subgroups, and a lower CRC mortality in women, indicating that beta-blocker initiation may improve long-term outcomes in this high-risk population.
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Emilsson et al. (2025) conducted a cohort in Colorectal polyps (n=30,399). Beta-blockers vs. Non-initiators was evaluated on Incident CRC (HR 0.87, 95% CI 0.85-0.89). Beta-blocker initiation within 2 years of first colorectal polyp diagnosis was associated with a lower 10-year cumulative incidence of CRC (HR 0.87; 95% CI 0.85-0.89).
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