title: Use of statins and the risk of death in patients with prostate cancer.
abstract: OBJECTIVE
  To determine whether the use of statins after prostate cancer diagnosis is associated with a decreased risk of cancer-related mortality and all-cause mortality and to assess whether this association is modified by prediagnostic use of statins.
  
  
  METHODS
  A cohort of 11,772 men newly diagnosed with nonmetastatic prostate cancer between April 1, 1998, and December 31, 2009, followed until October 1, 2012, was identified using a large population-based electronic database from the United Kingdom. Time-dependent Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs of mortality outcomes associated with postdiagnostic use of statins, lagged by 1 year to account for latency considerations and to minimize reverse causality, and considering effect modification by prediagnostic use of statins.
  
  
  RESULTS
  During a mean follow-up time of 4.4 years (standard deviation, 2.9 years), 3,499 deaths occurred, including 1,791 from prostate cancer. Postdiagnostic use of statins was associated with a decreased risk of prostate cancer mortality (HR, 0.76; 95% CI, 0.66 to 0.88) and all-cause mortality (HR, 0.86; 95% CI, 0.78 to 0.95). These decreased risks of prostate cancer mortality and all-cause mortality were more pronounced in patients who also used statins before diagnosis (HR, 0.55; 95% CI, 0.41 to 0.74; and HR, 0.66; 95% CI, 0.53 to 0.81, respectively), with weaker effects in patients who initiated the treatment only after diagnosis (HR, 0.82; 95% CI, 0.71 to 0.96; and HR, 0.91; 95% CI, 0.82 to 1.01, respectively).
  
  
  CONCLUSIONS
  Overall, the use of statins after diagnosis was associated with a decreased risk in prostate cancer mortality. However, this effect was stronger in patients who also used statins before diagnosis.
authors.affiliation: Oriana Yu, Maria Eberg, Samy Suissa, and Laurent Azoulay, Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital; Oriana Yu, Jewish General Hospital; Oriana Yu, Armen Aprikian, Gerald Batist, Samy Suissa, and Laurent Azoulay, McGill University; Serge Benayoun, University of Montreal; Armen Aprikian, McGill University Health Centre, McGill University; Gerald Batist and Laurent Azoulay, Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Oriana
authors.initials: O
authors.lastname: Yu
authors.forename: Maria
authors.initials: M
authors.lastname: Eberg
authors.forename: Serge
authors.initials: S
authors.lastname: Benayoun
authors.forename: Armen
authors.initials: A
authors.lastname: Aprikian
authors.forename: Gerald
authors.initials: G
authors.lastname: Batist
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
authors.forename: Laurent
authors.initials: L
authors.lastname: Azoulay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D015897:Comorbidity; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017430:Prostate-Specific Antigen