Continuing that Statin May Lower Cancer Risk
Continuing that Statin May Lower Cancer Risk
Abstract & Commentary
By Joseph E. Scherger, MD, MPH
Dr. Scherger reports no financial relationships relevant to this field of study.
Synopsis: A retrospective analysis of a large HMO population in Israel showed that persistent use of a statin medication over the 8-year period of analysis lowered the risk of cancer, particularly hematopoietic cancers by 31%.
Source: Lutski M, et al. Continuation with statin therapy and the risk of primary cancer: A population-based study. Prev Chronic Dis 2012;9:120005.
THERE IS BIOLOGIC EVIDENCE THAT STATINS MAY INHIBIT TUMOR GROWTH and possibly prevent carcinogenesis. After statins were introduced, effects other than lipid lowering, or pleiotropic effects, have been seen. The best known are anti-inflammatory effects. More than 15 years ago, statins were first shown in animal studies to inhibit tumor cell growth, metastasis of tumor cells, and induction of apoptosis.1 The authors describe the complex biochemistry of these actions. Statins have been associated with a significantly lower risk of breast,2 colorectal,3 and lymph cancers.4
These authors from Israel have been studying anticancer effects of statins. This is a retrospective study of the largest population to date of the impact of statins on cancer rates. They focused on breast, genitourinary, colorectal, lung, prostate, and hematopoietic malignancies.
The study was conducted in the second largest HMO population in Israel, Maccabi Healthcare Services (MHS), with a membership of more than 2 million persons. The data were obtained from MHS automated databases. The study population was 202,648 enrollees aged 21 or older who purchased at least one pack of statin medication from 1998 to 2006. Persistent use of the statin could be measured using pharmacy records. The mean follow-up period was 5 years for observing cancer incidence and death. There was no control group and the authors used the Israel Cancer Registry for comparison of cancer rates. The key to this study was the measurement of persistent use of a statin and cancer rates.
An inverse association was found between continued use of a statin and cancer risk for all the cancers, while adjusting for other confounding factors such as smoking rates. The most significant reductions were found with lymphomas and leukemias, a reduction of 31%.
Commentary
This study should be interpreted as suggestive only. We have been burned by other observational studies not panning out when randomized, controlled trials are done. Statin use in the United States and around the world is so great that overall reductions in one or more cancers should begin to show up.
There are many reasons we struggle to keep our patients taking their statin medication. The first muscle ache patients inevitably experience often gets blamed on the statin. The lay press frequently bashes statins, even though they may be the most lifesaving medications ever invented. Being able to suggest to patients that their statin medication may lower the risk of cancer is a good motivator for compliance that I intend to use.
References
1. Chan KK, et al. The statins as anticancer agents. Clin Cancer Res 2003;9:10-19.
2. Cauley JA, et al. Statin use and breast cancer: Prospective results from the Women’s Health Initiative. J Natl Cancer Inst 2006;98:700-707.
3. Poynter JN, et al. Statins and the risk of colorectal cancer. N Engl J Med 2005;352:2184-2192.
4. Fortuny J, et al. Statin use and risk of lymphoid neoplasms: Results from the European Case-Control Study EPILYMPH. Cancer Epidemiol Biomarkers Prev 2006;15:921-925.
A retrospective analysis of a large HMO population in Israel showed that persistent use of a statin medication over the 8-year period of analysis lowered the risk of cancer, particularly hematopoietic cancers by 31%.Subscribe Now for Access
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