title: Association between statin use and risk for keratinocyte carcinoma in the veterans affairs topical tretinoin chemoprevention trial.
abstract: BACKGROUND
  Recent evidence suggests that statins may prevent cancer.
  
  
  OBJECTIVE
  To quantify the association between statin use and the occurrence of keratinocyte carcinoma in high-risk veterans.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  6 Veterans Affairs medical centers.
  
  
  METHODS
  1037 participants of the Veterans Affairs Topical Tretinoin Chemoprevention Trial, a randomized, multicenter, double-blind, vehicle-controlled trial of topical tretinoin, 0.1%, for prevention of keratinocyte carcinoma conducted from November 1998 to November 2004.
  
  
  METHODS
  Time to first occurrence of keratinocyte carcinoma on the face or ears. Participants using a statin at randomization, according to the Veterans Affairs Pharmacy Benefits Management database, were considered exposed. Study dermatologists conducted physical examinations at baseline and every 6 months during follow-up. The association between statin use at randomization and the outcome was evaluated by using propensity score matching (n = 608) and Cox proportional hazards regression (n = 1037).
  
  
  RESULTS
  Among the 1037 participants, 37% used a statin at randomization (n = 397) for a median duration of at least 900 days over a median follow-up of 3.5 years. In the propensity score-matched analysis, statin use at randomization was not associated with keratinocyte carcinoma (rate ratio, 0.92 [95% CI, 0.73 to 1.16]), a finding that was consistent with the estimates derived from the Cox proportional hazards regression (rate ratio, 0.84 [CI, 0.70 to 1.02]).
  
  
  CONCLUSIONS
  The extent of residual confounding is unknown, and the confidence bounds around the measures of association were wide. These data may not be generalizable to lower-risk populations.
  
  
  CONCLUSIONS
  These data show no conclusive or consistent relationship between long-term statin use and risk for keratinocyte carcinoma.
authors.affiliation: i3 Drug Safety, Waltham, Massachusetts 02451, USA. david.dore@i3drugsafety.com
authors.forename: David D
authors.initials: DD
authors.lastname: Dore
authors.forename: Kate L
authors.initials: KL
authors.lastname: Lapane
authors.forename: Amal N
authors.initials: AN
authors.lastname: Trivedi
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000517:prevention & control*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000517:prevention & control*; D015986:Confounding Factors, Epidemiologic; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004428:Ear Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D005153:Facial Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D014212:Tretinoin / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin