Postdiagnosis statins may reduce prostate cancer mortality
medwireNews: Men who use statins in the period after a prostate cancer diagnosis have an almost 20% lower risk for death than those who do not, Danish researchers report.
However, whether or not the association is causal “remains to be established,” they remark.
The findings are based on an analysis of data for 31,790 Danish men aged 35 to 85 years who were diagnosed with prostate adenocarcinoma between 1998 and 2011.
The men were followed up for a median 2.8 years, beginning 1 year postdiagnosis to exclude deaths occurring in the first year. During the follow-up period, 7365 men died of prostate cancer and 11,811 died from other causes.
After adjustment for several potential confounders, including age, year of diagnosis, Gleason score, primary treatment type, and socioeconomic factors, men using postdiagnosis statins had a significant 17% lower risk for prostate cancer-specific mortality and a 19% lower risk for all-cause mortality than nonusers.
For the purposes of this study, postdiagnosis statin use was defined as two or more prescriptions filled after the prostate cancer diagnosis, and began 1 year after the second prescription was filled. “Thus, postdiagnosis statin users were regarded as nonusers until 1 year after their second statin prescription and then as users for the remainder of the follow-up period,” the researchers explain.
Sensitivity analyses focusing on statin use at 1 year and 5 years postdiagnosis showed similar results, and the findings were not modified by estimated dose or type of statin, clinical stage, Gleason score, or by prediagnosis statin use.
However, the researchers did find that patients who were diagnosed early in the study period or who underwent radical prostatectomy or endocrine therapy derived slightly greater benefit, in terms of prostate cancer-specific mortality, from postdiagnosis statin use than did those in the overall analyses.
Of note, 21% of patients used statins during the first year after prostate cancer diagnosis overall, but the figure was 4% among patients who were diagnosed from 1998 to 2001 rising to 29% among those who were diagnosed from 2007 to 2011.
Writing in the Journal of Clinical Oncology, Signe Benzon Larsen (Danish Cancer Society Research Center, Copenhagen) and colleagues say: “The potential of statins to prevent [prostate cancer] progression is compelling, as statins have a favorable safety profile and prevent cardiovascular disease.”
They conclude that more research is needed “to establish whether statins have genuine therapeutic potential” in prostate cancer management.
Editorialists Lorelei Mucci (Harvard TH Chan School of Public Health, Boston, Massachusetts, USA) and Philip Kantoff (Memorial Sloan Kettering Cancer Center, New York, USA) agree. They believe “it is timely to perform a prospective proof-of-concept trial before broadly prescribing statin use among men with prostate cancer.”
By Laura Cowen
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