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Statin Drugs and Risk of Advanced Prostate Cancer

Statins are commonly prescribed agents to lower cholesterol and the associated risks// of vascular events.

Statins are also known to have proapoptotic and antimetastatic effects in cancer. In fact, some studies inversely associate statin use with breast and colorectal cancers, but others to include epidemiologic ones have not supported this observation. Dr. Platz and colleagues evaluated over 30,000 men in a longitudinal health study with regard to statin use and risk of prostate cancer (CaP) and reported their findings in the December 20, 2006 issue of the Journal of the National Cancer Institute.

Study participants were enrolled in the Health Professionals Follow-up Study, an ongoing prospective cohort study of diet and other risk factors for heart disease, cancer and other conditions. It began in 1986 and questionnaires were completed biennially with an overall questionnaire response rate of 94%. Data regarding statin use began in 1990 and was thus the time of initiating study analysis. Medical records were obtained for men diagnosed with CaP. Stage T1a disease was excluded and participants were categorized as organ confined or advanced; regionally invasive, metastatic or fatal. Disease was also categorized as lower grade or higher grade. While 91% of all cholesterol drugs taken were statins, data on brand, type or dose was not acquired.

Between 1990 and 1994, 4.4% and 9.3%, respectively, of the men in the study reported using statins. This increased to 24% by the year 2000. Current use of statins was not associated with either total CaP or organ-confined disease after age adjustment or multivariable adjustment. Compared with nonuse of statins, current use was inversely associated with risk of advanced disease after adjusting for age and other CaP risk factors. The age-standardized incidence rate of advanced CaP for current statin users and nonusers was 38 and 89 per 100,000 person-years, respectively. This inverse association was even stronger for risk of metastatic and fatal CaP. Current use of statins was not associated with risk of either higher grade disease or lower grade disease. However, among ever-users of statins for 5 or more years, the relative risk of higher grade disease was lower than the relative risk of lower grade disease.

This epidemiologic study reports that men who currently used statin drugs had half the risk of advanced CaP and less than half the risk of metastatic or fatal CaP compared to men who did not currently use statins. The authors state that despite their data, it is premature to advocate the use of statins for chemoprevention of advanced CaP.

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