Review of recent evidence in support of a role for statins in the prevention of prostate cancer.
OBJECTIVE
We examine the potential chemopreventive role statins may have in prostate cancer, highlight the basic science supporting this role and analyze the human data regarding the association between statin use and prostate cancer.


RESULTS
Basic scientific evidence suggests that, through cholesterol and noncholesterol-mediated mechanisms, statins inhibit many pathways of cancer formation and progression. A handful of observational studies found statin use was associated with reduced prostate cancer risk, though others found no association. In the last year, however, four large prospective studies have observed similar reductions in the risk of advanced prostate cancer with essentially no reduction in the risk of overall prostate cancer. This may, in part, explain why previous studies, including large metaanalyses of clinical trials of statins in the prevention of cardiovascular outcomes, did not observe any association between statin use and overall prostate cancer risk.


CONCLUSIONS
The exact association between statin medication use and prostate cancer, and whether this association is causal in nature, remains unclear. Recent evidence, however, is encouraging, particularly for reducing the risk of advanced disease. Thus, while at present there are insufficient data to recommend all men start taking a statin medication regardless of their cholesterol profile, the rationale to move forward with further research is clear.
Hamilton
Robert J
RJ
Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Freedland
Stephen J
SJ
D000818:Animals; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D011471:Prostatic Neoplasms / Q000517:prevention & control*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors