Statin Therapy Lowers Mortality in Patients with Prostate Cancer

Jayson Slotnik, JD, MPH

February 2014, Vol 5, No 1 - In the Literature

Statin use has been shown to improve lipid profiles and to reduce cardiovascular morbidity and mortality. A 2012 study found that statins may have antitumor effects in various cancer types, including prostate cancer. Observational studies have investigated the association between statin use and different prostate cancer outcomes, but the findings were inconsistent. Also, these studies did not specifically assess whether the use of statins before the diagnosis of prostate cancer modified the association regarding the use of statins after diagnosis. In a new study, researchers examined the correlation between the use of statins after a prostate cancer diagnosis and the risk of cancer-related and all-cause mortality (Yu O, et al. J Clin Oncol. 2014;32:5-11).

The results are based on a large, population-based electronic database of 11,772 men in the United Kingdom. The cohort focused on patients newly diagnosed with nonmetastatic prostate cancer between April 1, 1998, and December 31, 2009, who were followed until October 1, 2012. The mean age at study entry was 71.3 years.

During a mean follow-up of 4.4 years, the researchers identified 3499 deaths, and 1791 (51%) of those were specific to prostate cancer. The postdiagnostic use of statin therapy was associated with a 24% risk reduction in mortality (HR, 0.76; 95% CI, 0.66-0.88). The results also showed a 14% decreased risk of all-cause mortality (HR, 0.86; 95% CI, 0.78-0.95), with the HRs gradually decreasing with longer cumulative durations of use. For patients who used statins before their diagnosis, these decreased risks were more pronounced (HR, 0.55; 95% CI, 0.41-0.74; and HR, 0.66; 95% CI, 0.53-0.81, respectively). However, weaker effects were observed in patients who started statins after diagnosis.

Overall, these findings indicate that statin use after a diagnosis of prostate cancer is correlated with a reduced risk of cancer-related mortality and all-cause mortality. This effect, however, was stronger in patients who also used statins before their diagnosis of prostate cancer, suggesting a possible effect of longer cumulative duration of use and higher cumulative doses. The researchers cautioned that additional well-conducted, observational studies are needed to validate these findings before initiating randomized controlled trials evaluating the effects of statins in the adjuvant setting.