title: Statin use and risk of prostate cancer in a population of men who underwent biopsy.
abstract: OBJECTIVE
  We determined the association between statin use and prostate cancer in men who underwent prostate biopsy.
  
  
  METHODS
  We performed a retrospective cohort study of men who underwent prostate biopsy from 2000 to 2007 at Cleveland Clinic. Statin use was determined using outpatient pharmacy records, and clinical and pathological outcomes were obtained. Multivariate logistic regression analysis to determine the effects of statins (and duration of use) was performed after adjusting for age, body mass index, African-American race, number of cores taken and prostate volume.
  
  
  RESULTS
  We analyzed data from 4,204 patients, and we identified 3,182 (75.7%) not on statins and 1,022 on statins. Men diagnosed with prostate cancer on statins compared to those not taking statins were less likely to have digital rectal examination positivity (5.3% vs 8.9%, OR 0.7, p <0.01), Gleason score 7 or greater prostate cancer (61.4% vs 72.4%, OR 0.78, p = 0.02) and high volume prostate cancer (27.2 vs 31.4, p <0.01). Moreover statin users had lower prostate specific antigen compared to nonstatin users (5.13 vs 5.98, p = 0.03). Multivariate analysis adjusted risk ratios for prostate cancer diagnosis, high grade prostate cancer (Gleason score 7 or greater) and 3 or more cores positive in statin users were 0.92 (95% CI 0.85-0.98), 0.76 (95% CI 0.67-0.85) and 0.86 (95% CI 0.75-0.97) and only high grade prostate cancer persisted with length of use.
  
  
  CONCLUSIONS
  Statin use was associated with a decreased risk of prostate cancer, less frequent high grade prostate cancer and lower volume of prostate cancer, suggesting that statin use has a protective effect against prostate cancer.
authors.affiliation: Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA. nelly.tan@gmail.com
authors.forename: Nelly
authors.initials: N
authors.lastname: Tan
authors.forename: Eric A
authors.initials: EA
authors.lastname: Klein
authors.forename: Jianbo
authors.initials: J
authors.lastname: Li
authors.forename: Ayman S
authors.initials: AS
authors.lastname: Moussa
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Jones
mesh_terms: D000368:Aged; D001706:Biopsy; D015331:Cohort Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors