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J Clin Oncol. 2014 Jan 1;32(1):5-11. doi: 10.1200/JCO.2013.49.4757. Epub 2013 Nov 4.

Use of statins and the risk of death in patients with prostate cancer.

Author information

1
Oriana Yu, Maria Eberg, Samy Suissa, and Laurent Azoulay, Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital; Oriana Yu, Jewish General Hospital; Oriana Yu, Armen Aprikian, Gerald Batist, Samy Suissa, and Laurent Azoulay, McGill University; Serge Benayoun, University of Montreal; Armen Aprikian, McGill University Health Centre, McGill University; Gerald Batist and Laurent Azoulay, Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada.

Abstract

PURPOSE:

To determine whether the use of statins after prostate cancer diagnosis is associated with a decreased risk of cancer-related mortality and all-cause mortality and to assess whether this association is modified by prediagnostic use of statins.

PATIENTS AND METHODS:

A cohort of 11,772 men newly diagnosed with nonmetastatic prostate cancer between April 1, 1998, and December 31, 2009, followed until October 1, 2012, was identified using a large population-based electronic database from the United Kingdom. Time-dependent Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs of mortality outcomes associated with postdiagnostic use of statins, lagged by 1 year to account for latency considerations and to minimize reverse causality, and considering effect modification by prediagnostic use of statins.

RESULTS:

During a mean follow-up time of 4.4 years (standard deviation, 2.9 years), 3,499 deaths occurred, including 1,791 from prostate cancer. Postdiagnostic use of statins was associated with a decreased risk of prostate cancer mortality (HR, 0.76; 95% CI, 0.66 to 0.88) and all-cause mortality (HR, 0.86; 95% CI, 0.78 to 0.95). These decreased risks of prostate cancer mortality and all-cause mortality were more pronounced in patients who also used statins before diagnosis (HR, 0.55; 95% CI, 0.41 to 0.74; and HR, 0.66; 95% CI, 0.53 to 0.81, respectively), with weaker effects in patients who initiated the treatment only after diagnosis (HR, 0.82; 95% CI, 0.71 to 0.96; and HR, 0.91; 95% CI, 0.82 to 1.01, respectively).

CONCLUSION:

Overall, the use of statins after diagnosis was associated with a decreased risk in prostate cancer mortality. However, this effect was stronger in patients who also used statins before diagnosis.

PMID:
24190110
DOI:
10.1200/JCO.2013.49.4757
[Indexed for MEDLINE]

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