Statins as agents to reduce risk for prostate cancer

In the past few years we have become used to seeing data from a range of studies suggesting that ongoing statin therapy is associated with both a lowered risk for diagnosis with prostate cancer and beneficial impact on the outcomes of treatment for prostate cancer once diagnosed. However, …

It is important to appreciate that not all studies in this arena have such positive results. And newly published epidemiological data from the Southern Community Cohort Study (SCCS) suggest no strong association between statin use and prostate cancer risk overall.

Most of the published data available to date on the association between statin therapy and risk for prostate cancer come from studies conducted in the white, non-Hispanic male population of America. By contrast, the 32,091 male participants in the SCCS were all aged between 40 and 79 years of age and 67 percent of the enrollees were non-Hispanic black men.

In this cohort, Kantor et al. found that, between initial study enrollment (from 2002 to 2009) and December 31, 2010,

  • 570 new cases of prostate cancer were diagnosed.
    • 324/570 cases (57.8 percent) were low-grade cancers (Gleason score < 7 or Gleason pattern 3 + 4)
    • 107/570 cases (18.8 percent) were high-grade cancers (Gleason score > 7 or Gleason pattern 4 + 3).
  • Among this patient cohort, use of statin therapy at study enrollment was observed in
    • 10 percent of non-Hispanic black men
    • 22 percent of non-Hispanic white men
  • As compared to non-use of statins, in multivariable models, statin use was associated with
    • A 14 percent overall reduction in risk for diagnosis of prostate cancer (hazard ratio [HR] = 0.86).
      • This reduction in risk for prostate cancer was not statistically significant.
    • A 38 percent reduction in risk for diagnosis of higher grade prostate cancers (HR = 0.62)
    • A 2 percent reduction in risk for diagnosis of lower grade prostate cancers (HR = 0.98)
  • Results were similar by race/ethnicity and did not vary by history of PSA testing.

Now as Kantor et al. observe, the study’s power to detect differences by subgroup is limited. However, if a modest effect of statin use on risk for diagnosis with prostate cancer does indeed exist, then in this cohort of patients it did not vary by race or ethnicity and it seems to have been restricted to men diagnosed with higher grades of cancer.

Apparently we still have a way to go before there is any real clarity about the value of statin therapy in the prevention and the management of prostate cancer — even though there have been some distinctly positive data from some studies in the relatively recent past (see, for example, here).

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