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.
Yu O, Eberg M, Benayoun S, Aprikian A, Batist G, Suissa S, Azoulay L. Are you the author?
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.
Reference: J Clin Oncol. 2013 Nov 4. Epub ahead of print.