Statin use and risk of prostate cancer: Results from the Southern Community Cohort Study

Elizabeth D. Kantor, Loren Lipworth, Jay Fowke, Edward L. Giovannucci, Lorelei A. Mucci, Lisa B. Signorello

Research output: Contribution to journalArticle

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Abstract

BACKGROUND Epidemiologic studies suggest that statin use may be inversely associated with risk of prostate cancer, but prior studies have focused predominantly on non-Hispanic white populations. METHODS We evaluated the association between statin use and prostate cancer risk in the Southern Community Cohort Study (SCCS). Study participants were 32,091 men aged 40-79 at baseline, 67% of whom were non-Hispanic black. Between study enrollment (2002-2009) and December 31, 2010, 570 prostate cancer cases were diagnosed, including 324 low-grade cancers (Gleason score <7 or Gleason pattern 3-+-4) and 107 high-grade cancers (Gleason score >7 or Gleason pattern 4-+-3). Analyses of overall prostate cancer were conducted using Cox regression and analyses of grade-specific cancer were conducted using competing risks models. RESULTS Ten percent of non-Hispanic black men and 22% of non-Hispanic white men reported use of statins at study enrollment. As compared to non-use, statin use was associated with a non-significant 14% lower risk of prostate cancer in multivariable models (Hazard Ratio [HR]:0.86; 95% Confidence Interval [CI]: 0.63-1.18). This association was stronger for high-grade cancer (HR: 0.62; 95%CI: 0.30, 1.28) than low-grade cancer (HR:0.98; 95%CI: 0.65-1.48). Results were similar by race/ethnicity (p-interaction: 0.41) and did not vary by history of prostate-specific antigen [PSA] screening (p-interaction: 0.65). CONCLUSIONS Results suggest no strong association between statin use and prostate cancer risk overall, and further suggest that if a modest protective effect does exist, it does not vary by race/ethnicity and may be restricted to high-grade tumors, although power to detect differences by subgroup was limited.

Original languageEnglish (US)
Pages (from-to)1384-1393
Number of pages10
JournalProstate
Volume75
Issue number13
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Prostatic Neoplasms
Cohort Studies
Confidence Intervals
Neoplasms
Neoplasm Grading
Prostate-Specific Antigen
Proportional Hazards Models
Epidemiologic Studies
Regression Analysis
Population

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

Kantor, E. D., Lipworth, L., Fowke, J., Giovannucci, E. L., Mucci, L. A., & Signorello, L. B. (2015). Statin use and risk of prostate cancer: Results from the Southern Community Cohort Study. Prostate, 75(13), 1384-1393. https://doi.org/10.1002/pros.23019

Statin use and risk of prostate cancer : Results from the Southern Community Cohort Study. / Kantor, Elizabeth D.; Lipworth, Loren; Fowke, Jay; Giovannucci, Edward L.; Mucci, Lorelei A.; Signorello, Lisa B.

In: Prostate, Vol. 75, No. 13, 01.09.2015, p. 1384-1393.

Research output: Contribution to journalArticle

Kantor, ED, Lipworth, L, Fowke, J, Giovannucci, EL, Mucci, LA & Signorello, LB 2015, 'Statin use and risk of prostate cancer: Results from the Southern Community Cohort Study', Prostate, vol. 75, no. 13, pp. 1384-1393. https://doi.org/10.1002/pros.23019
Kantor ED, Lipworth L, Fowke J, Giovannucci EL, Mucci LA, Signorello LB. Statin use and risk of prostate cancer: Results from the Southern Community Cohort Study. Prostate. 2015 Sep 1;75(13):1384-1393. https://doi.org/10.1002/pros.23019
Kantor, Elizabeth D. ; Lipworth, Loren ; Fowke, Jay ; Giovannucci, Edward L. ; Mucci, Lorelei A. ; Signorello, Lisa B. / Statin use and risk of prostate cancer : Results from the Southern Community Cohort Study. In: Prostate. 2015 ; Vol. 75, No. 13. pp. 1384-1393.
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abstract = "BACKGROUND Epidemiologic studies suggest that statin use may be inversely associated with risk of prostate cancer, but prior studies have focused predominantly on non-Hispanic white populations. METHODS We evaluated the association between statin use and prostate cancer risk in the Southern Community Cohort Study (SCCS). Study participants were 32,091 men aged 40-79 at baseline, 67{\%} of whom were non-Hispanic black. Between study enrollment (2002-2009) and December 31, 2010, 570 prostate cancer cases were diagnosed, including 324 low-grade cancers (Gleason score <7 or Gleason pattern 3-+-4) and 107 high-grade cancers (Gleason score >7 or Gleason pattern 4-+-3). Analyses of overall prostate cancer were conducted using Cox regression and analyses of grade-specific cancer were conducted using competing risks models. RESULTS Ten percent of non-Hispanic black men and 22{\%} of non-Hispanic white men reported use of statins at study enrollment. As compared to non-use, statin use was associated with a non-significant 14{\%} lower risk of prostate cancer in multivariable models (Hazard Ratio [HR]:0.86; 95{\%} Confidence Interval [CI]: 0.63-1.18). This association was stronger for high-grade cancer (HR: 0.62; 95{\%}CI: 0.30, 1.28) than low-grade cancer (HR:0.98; 95{\%}CI: 0.65-1.48). Results were similar by race/ethnicity (p-interaction: 0.41) and did not vary by history of prostate-specific antigen [PSA] screening (p-interaction: 0.65). CONCLUSIONS Results suggest no strong association between statin use and prostate cancer risk overall, and further suggest that if a modest protective effect does exist, it does not vary by race/ethnicity and may be restricted to high-grade tumors, although power to detect differences by subgroup was limited.",
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AU - Mucci, Lorelei A.

AU - Signorello, Lisa B.

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N2 - BACKGROUND Epidemiologic studies suggest that statin use may be inversely associated with risk of prostate cancer, but prior studies have focused predominantly on non-Hispanic white populations. METHODS We evaluated the association between statin use and prostate cancer risk in the Southern Community Cohort Study (SCCS). Study participants were 32,091 men aged 40-79 at baseline, 67% of whom were non-Hispanic black. Between study enrollment (2002-2009) and December 31, 2010, 570 prostate cancer cases were diagnosed, including 324 low-grade cancers (Gleason score <7 or Gleason pattern 3-+-4) and 107 high-grade cancers (Gleason score >7 or Gleason pattern 4-+-3). Analyses of overall prostate cancer were conducted using Cox regression and analyses of grade-specific cancer were conducted using competing risks models. RESULTS Ten percent of non-Hispanic black men and 22% of non-Hispanic white men reported use of statins at study enrollment. As compared to non-use, statin use was associated with a non-significant 14% lower risk of prostate cancer in multivariable models (Hazard Ratio [HR]:0.86; 95% Confidence Interval [CI]: 0.63-1.18). This association was stronger for high-grade cancer (HR: 0.62; 95%CI: 0.30, 1.28) than low-grade cancer (HR:0.98; 95%CI: 0.65-1.48). Results were similar by race/ethnicity (p-interaction: 0.41) and did not vary by history of prostate-specific antigen [PSA] screening (p-interaction: 0.65). CONCLUSIONS Results suggest no strong association between statin use and prostate cancer risk overall, and further suggest that if a modest protective effect does exist, it does not vary by race/ethnicity and may be restricted to high-grade tumors, although power to detect differences by subgroup was limited.

AB - BACKGROUND Epidemiologic studies suggest that statin use may be inversely associated with risk of prostate cancer, but prior studies have focused predominantly on non-Hispanic white populations. METHODS We evaluated the association between statin use and prostate cancer risk in the Southern Community Cohort Study (SCCS). Study participants were 32,091 men aged 40-79 at baseline, 67% of whom were non-Hispanic black. Between study enrollment (2002-2009) and December 31, 2010, 570 prostate cancer cases were diagnosed, including 324 low-grade cancers (Gleason score <7 or Gleason pattern 3-+-4) and 107 high-grade cancers (Gleason score >7 or Gleason pattern 4-+-3). Analyses of overall prostate cancer were conducted using Cox regression and analyses of grade-specific cancer were conducted using competing risks models. RESULTS Ten percent of non-Hispanic black men and 22% of non-Hispanic white men reported use of statins at study enrollment. As compared to non-use, statin use was associated with a non-significant 14% lower risk of prostate cancer in multivariable models (Hazard Ratio [HR]:0.86; 95% Confidence Interval [CI]: 0.63-1.18). This association was stronger for high-grade cancer (HR: 0.62; 95%CI: 0.30, 1.28) than low-grade cancer (HR:0.98; 95%CI: 0.65-1.48). Results were similar by race/ethnicity (p-interaction: 0.41) and did not vary by history of prostate-specific antigen [PSA] screening (p-interaction: 0.65). CONCLUSIONS Results suggest no strong association between statin use and prostate cancer risk overall, and further suggest that if a modest protective effect does exist, it does not vary by race/ethnicity and may be restricted to high-grade tumors, although power to detect differences by subgroup was limited.

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