AUA 2018: Prostate Cancer Incidence and Mortality among Men using Statins and Non-Statin Lipid-Lowering Medications

San Francisco, CA ( Statin drugs have been shown to protect against aggressive and lethal prostate cancer (PC), but most prior studies are limited by small study populations, relatively short follow-up, and confounding factors such as the possibility of unequal health care access. Moreover, previous research has not demonstrated that non-statin lipid-lowering medications (NSLLM) provide a similar benefit, which would support a cholesterol based mechanism underlying the statin effect.  

In this retrospective study the authors tested the hypothesis that cholesterol-lowering drugs (statins and NSLLM) affect PC incidence and severity. The authors abstracted prescription and health service records for 249,986 men aged 40-89 years from Saskatchewan, Canada between January 1, 1990 and December 31, 2014, and compared first-time statin and NSLLM users with age-matched non-users and glaucoma medication users for PC incidence, metastases at diagnosis, and PC mortality over 25 years using survival analysis.  

In comparing statin users to non-users, a weak association was detected with increased PC incidence (HR 1.07, 95% CI: 1.02-1.12) that disappeared when statin users were compared with glaucoma medication users. Substantial protective associations were observed between statin use and metastatic PC and PC mortality (HRs 0.69, 95% CI: 0.61-0.79, and 0.73, 95% CI: 0.66-0.81, respectively), which were stronger when compared with glaucoma medication use 

(Table). Similar associations were found between NSLLM use and PC incidence, severity and mortality (shown in the table as well). 

Screen Shot 2018 05 19 at 12.22.48 PM

These results provide the most comprehensive findings to date that statins may reduce the risk of metastatic PC and PC mortality, and the first to demonstrate that NSLLM have similar  effects, supporting a cholesterol-based mechanism. 

Presented By: Maria I. Van Rompay, Watertown, MA, US

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre Twitter: @GoldbergHanan at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA

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