title: Statin Use and Prostate Cancer Aggressiveness: Results from the Population-Based North Carolina-Louisiana Prostate Cancer Project.
abstract: Although statin use has been associated with reduced prostate cancer aggressiveness, the impact of race and patient characteristics on this association is not well understood. We examined the association between statin use and prostate cancer aggressiveness in Caucasians (CA) and African Americans (AA) and explored effect modification by health-seeking behaviors associated with statin use.
  
  
  
  Of 1,930 cases from The North Carolina-Louisiana Prostate Cancer Project, 344 (18%) were classified as aggressive based on clinical criteria. Utilizing nonaggressive cases as referent, logistic regression was used to examine the association between statin use and prostate cancer aggressiveness, overall and stratified by race. Smoking and prostate cancer screening were examined as effect modifiers of this association.
  
  
  
  There was an inverse association between statin use and prostate cancer aggressiveness [OR, 0.74; 95% confidence interval (CI), 0.56-0.96], with comparable effect estimates in both races. Although not statistically significant, statin use was associated with reduced ORs for aggressive prostate cancer in never-screened men (OR, 0.79; 95% CI, 0.45-1.39), men screened at low/recommended frequency (≤once/year; OR, 0.66; 95% CI, 0.41-1.06), and men screened at high frequency (>once/year; OR, 0.78; 95% CI, 0.53-1.15). Inverse associations between statins and aggressive prostate cancer were strongest in never smokers (OR, 0.42; 95% CI, 0.25-0.72), attenuated in former smokers (OR, 0.84; 95% CI, 0.59-1.19), and absent in current smokers (OR, 1.36; 95% CI, 0.70-2.64).
  
  
  
  Statin use was associated with reduced prostate cancer aggressiveness in CA and AAs, with strongest inverse associations in nonsmokers.
  
  
  
  Health-seeking behaviors associated with statin use should be considered when examining the impact of statins on prostate cancer aggressiveness. Cancer Epidemiol Biomarkers Prev; 25(4); 670-7. ©2016 AACR.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Emma H
authors.initials: EH
authors.lastname: Allott
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Laura
authors.initials: L
authors.lastname: Farnan
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Lenore
authors.initials: L
authors.lastname: Arab
authors.affiliation: Winthrop P. Rockefeller Cancer Institute and College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Su
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Merle
authors.initials: M
authors.lastname: Mishel
authors.affiliation: School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
authors.forename: Elizabeth T H
authors.initials: ET
authors.lastname: Fontham
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: James L
authors.initials: JL
authors.lastname: Mohler
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. jeannette_bensen@med.unc.edu.
authors.forename: Jeannette T
authors.initials: JT
authors.lastname: Bensen
mesh_terms: D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D011471:Prostatic Neoplasms / Q000517:prevention & control*; D016896:Treatment Outcome; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors