Factors mediating statin prostate cancer protective effect identified
medwireNews: Statin use is associated with a reduced risk for low- and high-Gleason score prostate cancer, but the association is modified by the duration, dose, and type of statin, study results suggest.
“Because [prostate cancer] is highly incident and few preventive strategies currently exist, elucidation of a benefit of statins in preventing [prostate cancer] could confer a considerable significance in public health,” emphasize Kai Wang (Harvard TH Chan School of Public Health, Boston, Massachusetts, USA) and colleagues.
As reported in Cancer Medicine, the team analyzed data on 13,065 men who visited the urologic clinic of a US institute for a prostatic condition between 1994 and 2016, and found a significant 20% reduced risk for prostate cancer among the 3839 men who used statins compared with nonusers.
Wang and colleagues note that the magnitude of risk reduction was greater with increasing duration of statin use, such that 11–29 months of use reduced the overall risk for prostate cancer by 23% versus no use, while the risk was 53% lower when statins were taken for 102 or more months.
By contrast, patients who received statins for a shorter duration of 1 to 10 months had an 88% increased risk for developing prostate cancer.
The findings were similar for the statin dose, with an increasing protective association with higher cumulative daily doses, but unlike the trend observed for short duration of use, lower cumulative daily doses were not linked to an increased risk for prostate cancer.
Subsequent Gleason score-stratified analysis on the 2976 men who developed prostate cancer showed that men who had taken statins were a significant 15% and 46% less likely to develop low-grade (Gleason score <7) and high-grade (Gleason score ≥7) prostate cancer, respectively, relative to nonusers.
And again, the protective effect of statins was greater with increasing duration of use and dose, for both Gleason low- and high-score disease.
Of note, statin use for 1–10 months was associated with a twofold increased risk for Gleason low-score prostate cancer, but there was no such adverse association in men with a high Gleason score.
The type of statin also modified the overall and high-grade prostate cancer risk whereby there was a significant reduction in risk only for men who took lipophilic statins, but not for those who took hydrophilic statins or a combination of both.
Wang et al state that theirs is “one of the largest longitudinal studies to have studied statin use in relation to Gleason score-specific [prostate cancer],” but they stress the need for additional research to confirm these findings and “elucidate involved mechanisms.”
By Hannah Kitt
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