title: Long-term Use of Statins and Risk of Renal Cell Carcinoma: A Population-based Case-Control Study.
abstract: Use of statins has been suggested to protect against renal cell carcinoma (RCC); however, studies have typically been underpowered, and the results are conflicting.
  
  
  
  To determine whether the use of statins is associated with a reduced risk of RCC using high-quality registry data.
  
  
  
  We conducted a nationwide case-control study based on all histologically verified cases of RCC in Denmark between 2002 and 2012 (n=4606) matched 1:10 to cancer-free controls. Data on drug use, comorbidity, and educational level were obtained from Danish nationwide prescription, patient, and demographic registries.
  
  
  
  Odds ratios (ORs) and 95% confidence intervals (CIs) for RCC associated with long-term use (≥5 yr) of statins were estimated using conditional logistic regression, adjusting for potential confounders.
  
  
  
  The adjusted OR for RCC associated with long-term use of statins was 1.06 (95% CI, 0.91-1.23). Analyses stratified by duration of statin use, type of statin, and patient characteristics all yielded ORs close to unity, except for a slightly increased OR for RCC associated with long-term statin use among women (OR: 1.25; 95% CI, 0.96-1.62). The main limitation of our study was lack of information on lifestyle factors, notably obesity, which may have biased the risk estimates upward.
  
  
  
  Our study does not support an important chemopreventive effect of long-term statin use against RCC. The marginally increased and statistically insignificant risk estimates can readily be interpreted as a null finding, considering the lack of control for obesity and other lifestyle risk factors.
  
  
  
  Previous studies have shown that the use of cholesterol-lowering drugs (statins) may protect against renal cancer. In a large study including all Danish renal cancers during an 11-yr period, we found no evidence of such an effect.
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense C, Denmark. Electronic address: apottegaard@health.sdu.dk.
authors.forename: Anton
authors.initials: A
authors.lastname: Pottegård
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Clinical Institute, University of Southern Denmark, Odense C, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Clark
authors.affiliation: Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen Ø, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Friis
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hallas
authors.affiliation: Clinical Institute, University of Southern Denmark, Odense C, Denmark; Department of Urology, Odense University Hospital, Odense C, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Lund
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000453:epidemiology* / Q000517:prevention & control; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D065840:Protective Factors; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Case–control study; Pharmacoepidemiology; Renal cancer; Statin