title: Prospective analysis of association between statins and pancreatic cancer risk in the Women's Health Initiative.
abstract: OBJECTIVE
  To determine whether HMG-CoA reductase inhibitors (statins) are associated with a lower risk of pancreatic cancer.
  
  
  METHODS
  The population included 160,578 postmenopausal women enrolled in the Women's Health Initiative (WHI) in which 385 incident cases of pancreatic cancer were identified over an average of 8.69 (SD ±4.59) years. All diagnoses were confirmed by medical record and pathology review. Information on statin use and other risk factors was collected at baseline and during follow-up. Multivariable-adjusted hazards ratios (HRs) and 95 % confidence intervals (CIs) evaluating the relationship between prior statin use (at baseline only as well as in a time-dependent manner) and risk of pancreatic cancer were computed from Cox proportional hazards regression analyses after adjusting for appropriate confounders. We also evaluated the effect of statin type, potency, lipophilic status, and duration of use. All statistical tests were two-sided.
  
  
  RESULTS
  Statins were used at baseline by 12,243 (7.5 %) women. The annualized rate of pancreatic cancer in statin users and nonusers, respectively, was 0.0298 versus 0.0271 %. The multivariable-adjusted HR for statin users versus nonusers at baseline was 0.92 and 95 % CI 0.57-1.48. In a time-dependent model, the HR for low-potency statins was 0.46, 95 % CI 0.20-1.04. There was no significant effect seen by statin lipophilicity or duration of use.
  
  
  CONCLUSIONS
  There was no significant relationship between statins and pancreatic cancer risk in the WHI; however, there was a marginal inverse association noted for low-potency statins. Analyses of larger numbers of cases are needed to further explore this relationship.
authors: Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA. simonm@karmanos.org.|Barbara Ann Karmanos Cancer Institute, 4100 John R, 4221 HWCRC, Detroit, MI, USA. simonm@karmanos.org.
authors: Michael S
authors: MS
authors: Simon
authors: Weill Cornell Medical College, New York, NY, USA.
authors: Pinkal
authors: P
authors: Desai
authors: Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA.
authors: Robert
authors: R
authors: Wallace
authors: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Chunyuan
authors: C
authors: Wu
authors: MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, Washington, DC, USA.
authors: Barbara V
authors: BV
authors: Howard
authors: George Washington University, Washington, DC, USA.
authors: Lisa W
authors: LW
authors: Martin
authors: Albert Einstein College of Medicine, Bronx, NY, USA.
authors: Nicolas
authors: N
authors: Schlecht
authors: UCLA School of Public Health, Los Angeles, CA, USA.
authors: Simin
authors: S
authors: Liu
authors: St John's Hospital and Medical Center, Detroit, MI, USA.
authors: Allison
authors: A
authors: Jay
authors: Center for Health Research, Kaiser Permanente NW, Portland, OR, USA.
authors: Erin S
authors: ES
authors: LeBlanc
authors: Albert Einstein College of Medicine, Bronx, NY, USA.
authors: Thomas
authors: T
authors: Rohan
authors: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors: JoAnn
authors: J
authors: Manson
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016387:Women's Health
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cancer risk; Pancreatic cancer; Statins