Journal Article

Association of statin use with risk of Gleason score‐specific prostate cancer: A hospital‐based cohort study

Gerke, Travis A., Chen, Xinguang, Wang, Kai, Prosperi, Mattia

2019

Overview

Background Conflicting evidence suggests that statins act chemopreventively against prostate cancer (PCa). Whether the association of statin use with PCa risk is Gleason score‐dependent, time‐, dose‐respondent is not well studied. Methods We conducted a cohort study at a tertiary hospital in the Southeastern US using longitudinal data of electronic medical records (EMR) from 1994 to 2016. Only cancer‐free men aged >18 years at baseline with follow‐up time of ≥12 months were included. Time‐dependent Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Results Among 13 065 men, 2976 were diagnosed with PCa over median follow‐up of 6.6 years. Statin use was associated with lower risk of both Gleason low‐ (score <7: aHR, 0.85; 95% CI, 0.74‐0.96) and high‐grade PCa (score ≥7: aHR, 0.54; 95% CI, 0.42‐0.69). The protective association was observed only when statins had been used for a relatively longer duration (≥11 months) or higher dose (≥121 defined daily doses), and were more pronounced for PCa of higher Gleason score (<7: aHR, 0.85, 95% CI, 0.74‐0.96; 7 [3 + 4]: aHR, 0.62, 95% CI, 0.43‐0.90; 7 [4 + 3]: aHR, 0.49, 95% CI, 0.29‐0.82; 8: aHR, 0.60, 95% CI, 0.37‐0.96; 9‐10: aHR, 0.24, 95% CI, 0.11‐0.54). Lipophilic statins (aHR, 0.83; 95% CI, 0.72‐0.95) might be more protective than hydrophilic statins (aHR, 0.91, 95% CI, 0.63‐1.33) against PCa. Conclusion Statin use might be associated with reduced PCa risk only when used for a relatively longer duration, and the risk reduction was higher for PCa of higher Gleason score. We found that statin use might be associated with reduced risk of both low‐ and high‐grade prostate cancer, but the reduced risk was observed only when statins had been used for a relatively longer duration or higher dose. Also, the statin‐related risk reduction was higher for prostate cancer of a higher Gleason score, and lipophilic statins might be more protective than hydrophilic statins against prostate cancer.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Aged / Bias / Cancer Prevention / Cohort analysis / dose‐response / Drug dosages / Electronic Health Records - statistics & numerical data / Electronic medical records / Follow-Up Studies / Gleason score / Health care / Hospitals / Humans / Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use / Lipophilic / lipophilicity / Male / Medical records / Middle Aged / Neoplasm Grading / Original Research / Prostate cancer / Prostatic Neoplasms - epidemiology / Prostatic Neoplasms - pathology / Prostatic Neoplasms - prevention & control / Risk Factors / Southeastern United States - epidemiology / Statins / Studies / Tertiary Care Centers - statistics & numerical data / Time Factors