Statin Answers

Statins may reduce cancer incidence in older patients

Reuters Health

January 8, 2008

In a large, retrospective cohort study of US veterans, statin use reduced the incidence of cancer by about 25%.

Although laboratory studies have indicated that statins can inhibit cancer cell progression, clinical trials have failed to confirm these findings, Dr. Wildon R. Farwell and his associates note in the January 16th Journal of the National Cancer Institute. They attribute the lack of evidence to the young age of trial participants and short follow-up periods.

To circumvent these limitations, Dr. Farwell, at VA Boston HealthCare System, and his associates analyzed data from the Veterans Affairs administrative and clinical databases.

They compared two cohorts: 26,000 patients who used antihypertensive medications but no cholesterol-lowering medications, and 27,000 patients who had used statins for at least 2 years. Mean age was 66.5 years, all were free of overt cancer at baseline, and median follow-up was 5.0 years (range 2.0 to 7.2 years). More than 96% were men.

The incidence of cancer was 9.4% among statin users and 13.2% among nonusers (p < .001).

After adjustment for age, weight, nonmalignant disease, smoking, cholesterol, and history of colonoscopy or sigmoidoscopy, the adjusted hazard ratio for first incidence of all cancer was 0.74.

The effect was statistically significant for colorectal cancer (adjusted HR 0.65), cancer of the lung (adjusted HR 0.70), and cancer of the prostate (adjusted HR 0.90).

There was also a significant dose response. For equivalent simvastatin doses of up to 10 mg, 11 - 39 mg, and 40 mg or higher, the corresponding hazard ratios for all cancers were 0.76, 0.72, and 0.67 (p for trend < .001).

"Observational studies and randomized trials to evaluate statins as cancer preventive agents are needed to confirm or refute these findings," Dr. Farwell and his associates conclude.

J Natl Cancer Inst 2008;100:134-139.