title: Statin use and risk of prostate cancer in the California Men's Health Study cohort.
abstract: Statins have known anticarcinogenic effects, however, evidence for long-term statin use as effective chemoprevention for prostate cancer is inconsistent. We examined the association between statin use and risk of prostate cancer among 69,047 eligible participants in the California Men's Health Study, a prospective cohort of Northern and Southern California Kaiser Permanente (KP) members, ages 45 to 69 years, initiated in 2002. Prostate cancer cases were identified by linkage to the KP California Cancer Registries. Statin exposure, estimated from automated KP outpatient pharmacy records (available since 1991 in Southern California and since 1994 in Northern California), was treated as time-varying and defined as the cumulative days dispensed of any statin from the first dispensing until a prostate cancer diagnosis, radical prostatectomy, termination of membership, or end of study (December 31, 2004). Cox proportional hazards models with age as the time scale were used to estimate rate ratios, while controlling for confounding variables. During follow-up, 888 prostate cancer cases, including 131 advanced cases, were identified. There was no association between ever statin use or <5 years use and prostate cancer. Conversely, >or=5 years use was associated with a 28% lower risk for prostate cancer compared with nonuse (adjusted rate ratio, 0.72; 95% confidence interval, 0.53-0.99). This association did not differ markedly for advanced disease. However, the association did seem to be restricted to those who regularly take nonsteroidal anti-inflammatory drugs. Our findings suggest that long-term statin use might be associated with a reduced risk of prostate cancer but perhaps only among regular nonsteroidal anti-inflammatory drug users.
authors.affiliation: Division of Research, Kaiser Permanente, 2000 Broadway, 5th Floor, Oakland, CA 94612, USA. eflick@post.harvard.edu
authors.forename: E Dawn
authors.initials: ED
authors.lastname: Flick
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Habel
authors.forename: K Arnold
authors.initials: KA
authors.lastname: Chan
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: Virginia P
authors.initials: VP
authors.lastname: Quinn
authors.forename: Reina
authors.initials: R
authors.lastname: Haque
authors.forename: Endel J
authors.initials: EJ
authors.lastname: Orav
authors.forename: John D
authors.initials: JD
authors.lastname: Seeger
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Sadler
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Whitmer
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Caan
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D006279:Health Maintenance Organizations; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control*; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017430:Prostate-Specific Antigen