Ever since it was recognized that there might be an association between taking statins (as a preventive treatment for elevated cholesterol levels) and risk for prostate cancer (which is now disputed), there has been an associated question as to whether men taking statins generally had a lower PSA level than men who were not, and what that might mean.
In an article published on line in Urology, Akduman et al. have addressed this question through the analysis of data from a cohort of nearly 5,000 patients. Evans has provided additional editorial comment on this study on the UroToday web site.
Akdumen and his colleagues based their analysis on data from 4,903 men who participated in screening studies during Prostate Cancer Awareness Week in 2007 and 2008. Patients were divided into two groups:
- Group A included 3,524 men (71.8 percent) who were not taking statin medication.
- Group B included 1,379 men (28.2 percent) who were on a statin medication.
Participants were asked to complete a self-administered questionnaire and were all given blood tests for PSA, testosterone, and total cholesterol levels. “Normal” levels of these tests were considered to be ≤ 4.0 ng/ml for PSA, ≤ 200 mg/dl for total serum cholesterol, and ≥ 400 ng/dl for serum testosterone.
Men taking drugs like finasteride, dutasteride, and other drugs known to alter androgen levels were excluded.
The results of the analysis showed the following:
- The average (mean) age of the participants was 60.7 years.
- Average (mean) serum levels of PSA, total cholesterol, and total testosterone were 1.5 ng/ml, 189.6 mg/dl, and 362.9 ng/dl, respectively.
- Men on statin medications (Group B) had statistically lower serum testosterone levels than men not receiving a statin (Group A).
- Average (mean) total cholesterol levels were similar in Groups A and B.
- Theaverage (mean) PSA level of men in Group B was 1.56 ng/ml as compared to 1.48 ng/ml among men in Group A.
- In a subgroup of men with normal cholesterol, normal testosterone, and nromal body mass index, there was no evidence of a difference in serum PSA levels between men taking or not taking a statin medication.
- After appropriate adjustments for age, race, and body mass index, use of statin medication was significantly associated with a lower mean PSA level and a lower mean testosterone level, but total cholesterol levels were the same in both groups of men.
Akduman et al. concluded that — even though statin medication does appear to induce a slight lowering of PSA levels — this effect is of limited clinical impact. They also concluded that there is unlikely to be any potential value to the use of a lower PSA cut-off to suggest risk for prostate cancer among men taking statin medications.
Filed under: Diagnosis, Prevention, Risk Tagged: | cholesterol, PSA, risk, statin, testosterone
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This is additional evidence along the line that statin drugs do not significantly decrease the incidence of prostate cancer. It’s worthwhile and interesting in that regard.
However, my impression is that the main value of a statin drug from a prostate cancer viewpoint is in substantially lowering the risk of advanced and deadly prostate cancer rather than on decreasing the incidence of prostate cancer, which apparently does not occur. It appears the risk reduction for advanced and deadly prostate cancer is greatest when a statin has been taken for 3 years or more.
That evidence leads me to think that taking a statin could be worthwhile for men at higher risk of prostate cancer, especially if there are cardiovascular benefits that are also likely.
A statin drug has been of great benefit to me in controling cholesterol and trigs while on a 10-year plus course of intermittent triple androgen deprivation therapy.