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The Risk of Cancer in Users of Statins

From the Academic Medical Center, Departments of Clinical Pharmacy and Oncology, Amsterdam; Department of Pharmaco-epidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht; and Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, the Netherlands

Address reprint requests to A.C.G. Egberts, PhD, Department of Pharmaco-epidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), PO Box 80082, 3508 TB, Utrecht, The Netherlands; e-mail: A.C.G.Egberts{at}pharm.uu.nl

PURPOSE: Several preclinical studies suggested a role for 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) in the treatment of cancer. The objective of this study was to compare the risk of incident cancer between users of statins and users of other cardiovascular medication.

METHODS: Data were used from the PHARMO database, containing drug dispensing records from community pharmacies and linked hospital discharge records for residents of eight Dutch cities. The study base included all patients with one or more prescriptions for cardiovascular drugs in the period between January 1, 1985 and December 31, 1998. Cases were identified as patients in the study base with a diagnosis of incident cancer and matched with four to six controls on sex, year of birth, geographic region, duration of follow-up, and index date. The analysis was adjusted for diabetes mellitus; prior hospitalizations; comorbidity; and use of diuretics, angiotensin-converting enzyme inhibitors, calcium-channel blockers, nonsteroidal anti-inflammatory drugs, sex hormones, and other lipid-lowering drug therapies.

RESULTS: In the study base, 3,129 patients were identified and matched to 16,976 controls. Statin use was associated with a risk reduction of cancer of 20% (adjusted odds ratio [OR], 0.80; 95% CI, 0.66 to 0.96). Our data suggest that statins are protective when used longer than 4 years (adjusted OR, 0.64; 95% CI, 0.44 to 0.93) or when more than 1,350 defined daily doses are taken (adjusted OR, 0.60; 95% CI, 0.40 to 0.91).

CONCLUSION: This observational study suggests that statins may have a protective effect against cancer.

Presented in part at the Meeting of the Royal Dutch Society of Clinical Pharmacology and Biopharmacy, October 10, 2002, Lunteren, the Netherlands; and the 39th Annual Meeting of the American Society of Clinical Oncology, May 31-June 3, 2003, Chicago, IL.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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