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Statin use and prostate cancer risk in a large population-based setting

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Abstract

Background

Statins are a commonly used cholesterol-lowering drug, which also have the potential to affect cancer risk and progression. Results from previous studies offer mixed conclusions.

Methods

To evaluate the relation between statin use and prostate cancer risk, we conducted a retrospective cohort study during 1 January 1990 to 31 August 2005 among men 45–79 years receiving care within Group Health, an integrated healthcare delivery system. Information on statin use and covariates were obtained from health plan databases. We identified incident prostate cancer cases through the Surveillance, Epidemiology, and End Results cancer registry. We used Cox proportional hazards models to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for prostate cancer among statin users compared to non-users.

Results

Among 83,372 men studied, median follow-up time was 5.7 years and 2,532 prostate cancer cases were identified. About 14.4% used statins over the study period and median duration of use was 3.3 years. Compared to non-users, hydrophobic statin users had a reduced risk of prostate cancer (HR = 0.79; 95% CI, 0.66–0.94), and results are suggestive of a reduced risk among ever users of statins (HR = 0.88; 95% CI, 0.76–1.02) and hydrophilic statin users (HR = 0.67; 95% CI, 0.33–1.34). There was no trend in risk by duration of statin use, and no association between statin use and cancer aggressiveness, stage, or grade.

Conclusion

Overall, this study does not support an associated between statin use and prostate cancer but a reduced risk cannot be ruled out.

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References

  1. National Cancer Institute SEER cancer statistics review. Bethesda. Available: http://seer.cancer.gov/csr/1975_2001. Accessed August 23, 2007

  2. Sewester CS, Dombek CE, Olin BR, Kastrup EK, Hebel SK (2004) Drug facts and comparisons. Wolters Kluwer Health, St. Louis

    Google Scholar 

  3. RX List. The Top 200 Prescriptions for 2004 by U.S. Sales. Available at: http://www.rxlist.com/top200_sales_2004. Accessed May 10, 2005

  4. Wong WW, Dimitroulakos J, Minden MD, Penn LZ (2002) HMG-CoA reductase inhibitors and the malignant cell: the statin family of drugs as triggers of tumor-specific apoptosis. Leukemia 16:508–519

    Article  PubMed  CAS  Google Scholar 

  5. Chan KK, Oza AM, Siu LL (2003) The statins as anticancer agents. Clin Cancer Res 9:10–19

    PubMed  CAS  Google Scholar 

  6. Goldstraw MA, Amoroso P, Kirby RS (2006) Do statins protect against prostate cancer? BJU Int 97:1147–1148

    Article  PubMed  Google Scholar 

  7. Olsen JH, Johansen C, Sorensen HT, McLaughlin JK, Mellemkjaer L, Steffensen FH et al (1999) Lipid-lowering medication and risk of cancer. J Clin Epidemiol 52:167–169

    Article  PubMed  CAS  Google Scholar 

  8. Coogan PF, Rosenberg L, Strom BL (2007) Statin use and the risk of 10 cancers. Epidemiology 18:213–219

    Article  PubMed  Google Scholar 

  9. Murtola TJ, Tammela TL, Lahtela J, Auvinen A (2007) Cholesterol-lowering drugs and prostate cancer risk: a population-based case–control study. Cancer Epidemiol Biomarkers Prev 16:2226–2232

    Article  PubMed  CAS  Google Scholar 

  10. Jacobs EJ, Rodriguez C, Bain EB, Wang Y, Thun MJ, Calle EE (2007) Cholesterol-lowering drugs and advanced prostate cancer incidence in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 16:2213–2217

    Article  PubMed  CAS  Google Scholar 

  11. Platz EA, Leitzmann MF, Visvanathan K, Rimm EB, Stampfer MJ, Willett WC et al (2006) Statin drugs and risk of advanced prostate cancer. J Natl Cancer Inst 98:1819–1825

    PubMed  CAS  Google Scholar 

  12. Blais L, Desgagne A, LeLorier J (2000) 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and the risk of cancer: a nested case–control study. Arch Intern Med 160:2363–2368

    Article  PubMed  CAS  Google Scholar 

  13. Coogan PF, Rosenberg L, Palmer JR, Strom BL, Zauber AG, Shapiro S (2002) Statin use and the risk of breast and prostate cancer. Epidemiology 13:262–267

    Article  PubMed  Google Scholar 

  14. Shannon J, Tewoderos S, Garzotto M, Beer TM, Derenick R, Palma A et al (2005) Statins and prostate cancer risk: a case–control study. Am J Epidemiol 162:318–325

    Article  PubMed  Google Scholar 

  15. Flick ED, Habel LA, Chan KA, Van Den Eeden SK, Quinn VP, Haque R et al (2007) Statin use and risk of prostate cancer in the California men’s health study cohort. Cancer Epidemiol Biomarkers Prev 16:2218–2225

    Article  PubMed  CAS  Google Scholar 

  16. Singal R, Khurana V, Caldito G, Fort C (2005) Statins and prostate cancer risk: a large case–control study in veterans. J Clin Oncol, 2005 ASCO Annual Meeting Proceedings 23:1004

    Google Scholar 

  17. Graaf MR, Beiderbeck AB, Egberts AC, Richel DJ, Guchelaar HJ (2004) The risk of cancer in users of statins. J Clin Oncol 22:2388–2394

    Article  PubMed  CAS  Google Scholar 

  18. Kaye JA, Jick H (2004) Statin use and cancer risk in the general practice research database. Br J Cancer 90:635–637

    Article  PubMed  CAS  Google Scholar 

  19. Moyad MA, Merrick GS, Butler WM, Wallner KE, Galbreath RW, Kurko B et al (2005) Statins, especially atorvastatin, may favorably influence clinical presentation and biochemical progression-free survival after brachytherapy for clinically localized prostate cancer. Urology 66:1150–1154

    Article  PubMed  Google Scholar 

  20. Moyad MA, Merrick GS, Butler WM, Wallner KE, Galbreath RW, Butler EG et al (2006) Statins, especially atorvastatin, may improve survival following brachytherapy for clinically localized prostate cancer. Urol Nurs 26:298–303

    PubMed  Google Scholar 

  21. Browning DR, Martin RM (2007) Statins and risk of cancer: a systematic review and metaanalysis. Int J Cancer 120:833–843

    Article  PubMed  CAS  Google Scholar 

  22. Ford I, Murray H, Packard CJ, Shepherd J, Macfarlane PW, Cobbe SM (2007) Long-term follow-up of the west of Scotland Coronary Prevention Study. N Engl J Med 357:1477–1486

    Article  PubMed  CAS  Google Scholar 

  23. Bjerre LM, LeLorier J (2001) Do statins cause cancer? A meta-analysis of large randomized clinical trials. Am J Med 110:716–723

    Article  PubMed  CAS  Google Scholar 

  24. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C et al (2005) Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 366:1267–1278

    Article  PubMed  CAS  Google Scholar 

  25. Dale KM, Coleman CI, Henyan NN, Kluger J, White CM (2006) Statins and cancer risk: a meta-analysis. JAMA 295:74–80

    Article  PubMed  CAS  Google Scholar 

  26. Bonovas S, Filioussi K, Tsavaris N, Sitaras NM (2005) Use of statins and breast cancer: a meta-analysis of seven randomized clinical trials and nine observational studies. J Clin Oncol 23:8606–8612

    Article  PubMed  Google Scholar 

  27. Bonovas S, Filioussi K, Tsavaris N, Sitaras NM (2006) Statins and cancer risk: a literature-based meta-analysis and meta-regression analysis of 35 randomized controlled trials. J Clin Oncol 24:4808–4817

    Article  PubMed  CAS  Google Scholar 

  28. Bonovas S, Filioussi K, Flordellis CS, Sitaras NM (2007) Statins and the risk of colorectal cancer: a meta-analysis of 18 studies involving more than 1.5 million patients. J Clin Oncol 25:3462–3468

    Article  PubMed  Google Scholar 

  29. Boudreau DM, Yu O, Miglioretti DL, Buist DS, Heckbert SR, Daling JR (2007) Statin use and breast cancer risk in a large population-based setting. Cancer Epidemiol Biomarkers Prev 16:416–421

    Article  PubMed  CAS  Google Scholar 

  30. Saunders KW, Davis RL, Stergachis A (2005) Group health cooperative. In: Strom B (ed) Pharmacoepidemiology. John Wiley and Sons, Chichester, pp 223–239

    Google Scholar 

  31. Boudreau DM, Doescher MP, Jackson JE, Fishman PA (2004) Impact of healthcare delivery system on where HMO-enrolled seniors purchase medications. Ann Pharmacother 38:1317–1318

    PubMed  Google Scholar 

  32. Buist DS, LaCroix AZ, Brenneman SK, Abbott T (2004) A population-based osteoporosis screening program: who does not participate, and what are the consequences? J Am Geriatr Soc 52:1130–1137

    Article  PubMed  Google Scholar 

  33. Taplin SH, Ichikawa L, Buist DS, Seger D, White E (2004) Evaluating organized breast cancer screening implementation: the prevention of late-stage disease? Cancer Epidemiol Biomarkers Prev 13:225–234

    Article  PubMed  Google Scholar 

  34. Washington State Department of Health, Center for Health Statistics (2003) Washington State Vital Statistics, 2002. Available at: http://www.doh.wa.gov/ehsphl/chs/chs-data/Public/AnnSum_2002. Accessed 17 Sept 2004

  35. Newton KM, Wagner EH, Ramsey SD, McCulloch D, Evans R, Sandhu N et al (1999) The use of automated data to identify complications and comorbidities of diabetes: a validation study. J Clin Epidemiol 52:199–207

    Article  PubMed  CAS  Google Scholar 

  36. Hosmer DW Jr, Lemeshow S (1999) Applied survival analysis: regression modeling of time to event data. John Wiley & Sons, New York

    Google Scholar 

  37. Hastie T, Tibshirani R, Friedman J (eds) (2001) The elements of statistical learning; data mining, inference, and prediction. Springer, New York

  38. Agency for Healthcare Research and Quality (2006) The Guide to Clinical Preventive Services 2006. Available at: http://www.ahrq.gov/clinic/pocketgd.pdf. Accessed 25 July 2007

  39. Duncan RE, El-Sohemy A, Archer MC (2005) Statins and cancer development. Cancer Epidemiol Biomarkers Prev 14:1897–1898

    Article  PubMed  CAS  Google Scholar 

  40. Cauley JA, McTiernan A, Rodabough RJ, LaCroix A, Bauer DC, Margolis KL et al (2006) Statin use and breast cancer: prospective results from the Women’s Health Initiative. J Natl Cancer Inst 98:700–707

    Article  PubMed  CAS  Google Scholar 

  41. Sprague JR, Wood ME (2006) Statins and breast cancer prevention: time for randomized controlled trials. J Clin Oncol 24:2129–2130; author reply 2130–2131

    Article  PubMed  Google Scholar 

  42. Cyrus-David MS, Weinberg A, Thompson T, Kadmon D (2005) The effect of statins on serum prostate specific antigen levels in a cohort of airline pilots: a preliminary report. J Urol 173:1923–1925

    Article  PubMed  CAS  Google Scholar 

  43. Sivaprasad U, Abbas T, Dutta A (2006) Differential efficacy of 3-hydroxy-3-methylglutaryl CoA reductase inhibitors on the cell cycle of prostate cancer cells. Mol Cancer Ther 5:2310–2316

    Article  PubMed  CAS  Google Scholar 

  44. Platz EA (2007) Epidemiologic musing on statin drugs in the prevention of advanced prostate cancer. Cancer Epidemiol Biomarkers Prev 16:2175–2180

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We thank Deborah Seger, Dawn Fitzgibbons, Janet Stanford, and Ilir Agalliu for their valuable contributions. This study was supported by the National Cancer Institute (CA108357).

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Correspondence to Denise M. Boudreau.

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Boudreau, D.M., Yu, O., Buist, D.S.M. et al. Statin use and prostate cancer risk in a large population-based setting. Cancer Causes Control 19, 767–774 (2008). https://doi.org/10.1007/s10552-008-9139-4

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  • DOI: https://doi.org/10.1007/s10552-008-9139-4

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