Statins May Reduce Prostate Cancer Risk

Statins May Reduce Prostate Cancer Risk.

Cancer patients who used statins (cholesterol-lowering drugs) prior to their cancer diagnosis have a 15 percent lower risk of dying from cancer, according to the results of a study published in then New England Journal of Medicine. (1)

Statins are cholesterol-lowering drugs and are the most commonly prescribed class of prescription drugs in the United States. Some but not all studies have suggested that in addition to their cardiovascular effects, statins may help to reduce the risk of certain cancers, including prostate cancer and colorectal cancer. (2-7)

New Guidelines Could Add 12.8 Million New Statin Users

The new American College of Cardiology–American Heart Association (ACC-AHA) guidelines for managing cholesterol—if adhered to strictly—would increase the number of adults eligible for statin therapy by 12.8 million, according to the results of a study published in the New England Journal of Medicine.[1] This increase would be seen mostly among older adults without cardiovascular disease.

The results indicated that the new guidelines would increase the number of U.S. adults eligible for statin therapy from 43.2 million to 56.0 million. Most of this increase (10.4 million of 12.8 million) would occur among adults without cardiovascular disease. The percentage of 60-75-year-olds without cardiovascular disease that would become eligible would increase dramatically—from 30.4 percent to 87.4 percent among men and from 21.2 percent to 53.6 percent among women.

Statins and Prostate Cancer

The use of cholesterol-lowering statins is also associated with a decline in prostate specific antigen (PSA) levels. (1,2) Furthermore, some evidence has linked statins with the prevention of cancer, including a Finnish study that reported a 50-65% reduction in prostate cancer risk among statin users versus non-users.

According to a recent retrospective study, men who used statin drugs had a lower risk of prostate cancer but only with prolonged use or higher doses. (3)

A history of treatment with statins was associated with a 15% reduction in the relative risk of low-grade prostate cancer and a 46% lower risk of developing high-grade disease. The association was limited to men who took statins for at least 11 months.

To further address the impact of statin use on prostate cancer researchers evaluated 13,065 medical records of men visiting a urologist between November 1994 and January 2016 for individuals newly diagnosed with prostate cancer. Overall 2,976 prostate cancers were diagnosed, 2,308 of which were low grade (Gleason score <7) and 668 high grade (Gleason score ≥7). Medical records showed that 3,839 men used statins during the study period and when evauated the study authors discerned that Statin use was associated with a reduced risk of low- and high-grade PCa, as compared with no statin use.

· Statin use was associated with a 20% reduction in the risk of PCa overall.

· There was an inverse association between PCa risk and cumulative duration of statin use and cumulative dose.

· The protective effect on PCa risk was limited to longer duration of statin use.

· Patients who used statins for 1-10 months had an increased risk of PCa.

Only lipophilic statins had a significant association with decreased PCa risk and appeared to be more protective against prostate cancer than did hydrophilic drugs. (3)

· Fluvastatin

· Lovastatin

· Simvastatin

· Atorvastati

· Cerivastatin

· 1. Hamilton RJ, Goldberg KC, Platz EA. The influence of statin medications on prostate-specific antigen levels. Journal of the National Cancer Institute. 2008;100:1511-1518.

  1. Murtola TJ, Tammela TLJ, Maattanen L. Statins and prostate cancer among men participating in the Finnish Prostate Cancer Screening Trial. American Urological Association Meeting, Anaheim, California; 2007. Abstract 1719. http://www.abstracts2view.com/aua/index.php.

[1] Hamilton RJ, Banez LL, Aronson WJ, et al. Statin Medication Use and the Risk of Biochemical Recurrence After Radical Prostatectomy: Results From the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Cancer [early online publication]. June 28, 2010.

[2] Gutt R, Tonlaar N, Kunnavakkam R, et al. Statin use and risk of prostate cancer recurrence in men treated with radiation therapy. Journal of Clinical Oncology [early online publication]. April 26, 2010.

References:

[4] Bonovas S, Filioussi K, Flordellis CS, Sitaras NM. Statins and risk of colorectal cancer: a meta-analysis of 18 studies involving more than 1.5 million patients. Journal of Clinical Oncology. 2007;25:3462-3468.

[5] Coogan PF, Smith J, Rosenberg L. Statin Use and Risk of Colorectal Cancer. Journal of the National Cancer Institute. 2007;99:32-40.

[6] Stone NJ, Robinson J, Lichtenstein AH, et al: 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. Published early online November 2013. doi:10.1016/j.jacc.2013.11.002

melanoma no

Freeman SR, Drake AL, Heilig LF et al. Statins, Fibrates, and Melanoma Risk: a Systematic Review and Meta-analysis. Journal of the National Cancer Institute. 2006;98:1538-46.

Breat no

Cauley J, McTiernan A, Rodabough R, et al. Statin Use and Breast Cancer: Prospective Results From the Women’s Health Initiative. Journal of the National Cancer Institute. 2006; 10: 700-707.

Eliassen AH, Colditz GA, Rosner B et al. Serum lipids, lipid-lowering drugs, and the risk of breast cancer. Archives of Internal Medicine . 2005;165:2264-2271.

colon no

Coogan PF, Smith J, Rosenberg L. Statin Use and Risk of Colorectal Cancer. Journal of the National Cancer Institute. 2007;99:32-40.

Bonovas S, Filioussi K, Flordellis CS, Sitaras NM. Statins and risk of colorectal cancer: a meta-analysis of 18 studies involving more than 1.5 million patients. Journal of Clinical Oncology. 2007;25:3462-3468.

[1] Simon MS, Rosenber CA, Rodabough RA, et al. Prospective analysis of the association between use of statins or other lipid-lowering agents and colorectal cancer risk. Ninth Annual AACR Frontiers in Cancer Prevention Research Conference. Philadelphia, PA. November 7-10. [Abstract A59]

yes reduce risk or improve survival

Poynter J, Rennert G, Bonner J, et al. HMG CoA reductase inhibitors and the risk for colorectal cancer. Proceedings from the 40th annual meeting of American Society of Clinical Oncology, New Orleans, LA, June 5-8, 2004; Abstract

Cardwell CR, Hicks BM, Hughes C, Murray L. Statin Use After Colorectal Cancer Diagnosis and Survival: A Population-Based Cohort Study. J Clin Oncol. 2014 Aug 4. pii: JCO.2013.54.4569. [Epub ahead of print]

Researchers from Denmark used data from the Danish national database to assess mortality among patients from the entire Danish population who were diagnosed with cancer between 1995 and 2007, with follow-up until 2009. They found that among patients age 40 or older, 18,721 had used statins regularly prior to their cancer diagnosis and 277,204 had never used statins.

During 1,072,503 person-years of follow-up, 162,067 patients died of cancer, 14,489 died of cardiovascular disease, and 19,038 died from other causes. The analysis showed that the risk of cancer death was significantly lower (15 percent) among statin users than those who had never used statins. What’s more—all-cause mortality (the risk of death from any cause) was also lower among statin users. The outcomes were similar regardless of the statin dose.

The reasons for the association are unclear. The researchers noted that statin use could simply be a marker of increased health awareness, which could bias the results. Research will likely be ongoing to continue to evaluate the relationship between statin use and cancer death.

To explore the effects of statin use on risk of prostate cancer, researchers evaluated information from the Olmsted County Study of Urinary Health Status among Men. In this study, researchers followed 2,447 men—all residents of Olmsted County, Minnesota—for over 15 years.

  • Compared with statin users, non-users of statins were three times more likely to develop prostate cancer.

These results suggest that in addition to reducing the risk of cardiovascular disease, statins may also have prostate benefits. The researchers emphasize, however, that these results are preliminary and will need to be confirmed by other studies.

Reference: Breau L et al. Statins may reduce risk of prostate cancer. Presented at the 2009 annual meeting of the American Urological Association.

Men who have used statin drugs to reduce their cholesterol levels may be less likely to develop prostate cancer, according to a study published in the American Journal of Epidemology.

The prostate is a gland of the male reproductive system that produces fluid that transports the sperm during ejaculation. In prostate cancer, cancer cells form in the tissues of the prostate. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men.

Statins are a group of cholesterol-lowering drugs that include pravastatin and simvastatin. Some studies have reported a reduced risk of certain types of cancer among patients who have taken statins.

To evaluate the relationship between statin use and risk of prostate cancer, researchers conducted a study among patients at the Portland, Oregon, Veterans Affairs Medical Center. The study involved 100 men with prostate cancer and 202 men without prostate cancer. Information about statin use was collected from an electronic pharmacy database.

The study found that the men with prostate cancer were less likely than the men without prostate cancer to have used statins. Thirty-six percent of the men with prostate cancer had used statins, compared to 49 percent of the men without prostate cancer. The difference in statin use between men with and without prostate cancer was especially apparent for men with prostate cancer who had high Gleason scores (indicating high-grade, more aggressive prostate cancer). When comparing men with prostate cancer and high Gleason scores to men without prostate cancer, statin use was associated with a 75% reduction in the risk of developing prostate cancer.

Since this was an observational study, rather than a randomized clinical trial, the results should be interpreted with caution. In an observational study, researchers do not assign patients to a particular treatment; rather, they simply observe what happens to patients after they have decided themselves whether or not to take the treatment. Patients who take a certain medication, such as statins, may differ from patients who do not take the medication, and these differences may affect the study results. Researchers attempt to account for differences between patient groups when analyzing the data, but some differences may be unknown or difficult to measure.

The researchers conclude that statins may reduce the risk of prostate cancer, particularly more aggressive forms of the disease. Further investigation of the effects of statins in cancer prevention is warranted.

Reference: Shannon J, Tewoderos S, Garzotto M et al. Statins and prostate cancer risk: A case-control study. American Journal of Epidemiology. 2005;162:318-325.

Reference:

  1. Nielsen SF, Nordestgaard BG, Bojesen SE. Statin Use and Reduced Cancer-Related Mortality. New England Journal of Medicine. 2012; 367: 1792-1802.
  2. Hamilton RJ, Banez LL, Aronson WJ, et al. Statin Medication Use and the Risk of Biochemical Recurrence After Radical Prostatectomy: Results From the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Cancer [early online publication]. June 28, 2010.
  3. Gutt R, Tonlaar N, Kunnavakkam R, et al. Statin use and risk of prostate cancer recurrence in men treated with radiation therapy. Journal of Clinical Oncology [early online publication]. April 26, 2010.
  4. Bonovas S, Filioussi K, Flordellis CS, Sitaras NM. Statins and risk of colorectal cancer: a meta-analysis of 18 studies involving more than 1.5 million patients. Journal of Clinical Oncology. 2007;25:3462-3468.
  5. Hamilton RJ, Goldberg KC, Platz EA. The influence of statin medications on prostate-specific antigen levels. Journal of the National Cancer Institute. 2008;100:1511-1518.
  6. Murtola TJ, Tammela TLJ, Maattanen L. Statins and prostate cancer among men participating in the Finnish Prostate Cancer Screening Trial. American Urological Association Meeting, Anaheim, California; 2007. Abstract 1719. http://www.abstracts2view.com/aua/index.php.
  7. https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.2500

[5] Coogan PF, Smith J, Rosenberg L. Statin Use and Risk of Colorectal Cancer. Journal of the National Cancer Institute. 2007;99:32-40.

[1] Pencina MJ, Navar-Boggan AM, D’Agostino RB, et al: Application of new cholesterol guidelines to a population-based sample. New England Journal of Medicine. Published early online March 19, 2014. DOI: 10.1056/NEJMoa1315665

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