Statin use and all-cancer survival: prospective results from the Women's Health Initiative.
BACKGROUND
This study aims to investigate the association between statin use and all-cancer survival in a prospective cohort of postmenopausal women, using data from the Women's Health Initiative Observational Study (WHI-OS) and Clinical Trial (WHI-CT).


METHODS
The WHI study enrolled women aged 50-79 years from 1993 to 1998 at 40 US clinical centres. Among 146 326 participants with median 14.6 follow-up years, 23 067 incident cancers and 3152 cancer deaths were observed. Multivariable-adjusted Cox proportional hazards models were used to investigate the relationship between statin use and cancer survival.


RESULTS
Compared with never-users, current statin use was associated with significantly lower risk of cancer death (hazard ratio (HR), 0.78; 95% confidence interval (CI), 0.71-0.86, P<0.001) and all-cause mortality (HR, 0.80; 95% CI, 0.74-0.88). Use of other lipid-lowering medications was also associated with increased cancer survival (P-interaction (int)=0.57). The lower risk of cancer death was not dependent on statin potency (P-int=0.22), lipophilicity/hydrophilicity (P-int=0.43), type (P-int=0.34) or duration (P-int=0.33). However, past statin users were not at lower risk of cancer death compared with never-users (HR, 1.06; 95% CI, 0.85-1.33); in addition, statin use was not associated with a reduction of overall cancer incidence despite its effect on survival (HR, 0.96; 95% CI, 0.92-1.001).


CONCLUSIONS
In a cohort of postmenopausal women, regular use of statins or other lipid-lowering medications was associated with decreased cancer death, regardless of the type, duration, or potency of statin medications used.
Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Ange
A
Wang
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Aaron K
AK
Aragaki
Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Jean Y
JY
Tang
Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA.|Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94035, USA.
Allison W
AW
Kurian
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
JoAnn E
JE
Manson
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
Rowan T
RT
Chlebowski
Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI 48344, USA.
Michael
M
Simon
Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA.
Pinkal
P
Desai
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Sylvia
S
Wassertheil-Smoller
Department of Medicine, Brown University School of Medicine, Providence, RI 02903, USA.
Simin
S
Liu
Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Stephen
S
Kritchevsky
Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Heather A
HA
Wakelee
Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA.
Marcia L
ML
Stefanick
D000368:Aged; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D064887:Observational Studies as Topic; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016387:Women's Health
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors