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Prostate cancer and PSA among statin users in the Finnish prostate cancer screening trial
Author(s) -
Murtola Teemu J.,
Tammela Teuvo L.J.,
Määttänen Liisa,
Huhtala Heini,
Platz Elizabeth A.,
AlaOpas Martti,
Stenman UlfHåkan,
Auvinen Anssi
Publication year - 2010
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.25165
Subject(s) - medicine , prostate cancer , statin , hazard ratio , cancer , oncology , incidence (geometry) , prostate cancer screening , cohort , population , cancer registry , proportional hazards model , relative risk , confidence interval , prostate , gynecology , prostate specific antigen , physics , environmental health , optics
Decreased risk of advanced prostate cancer has been reported among men using statins. However, the evidence on overall prostate cancer risk is conflicting. We compared the relative risk between current users and non‐users of statins or other cholesterol‐lowering medications in a population undergoing systematical prostate cancer screening. The study cohort comprised of 23,320 men participating in the screening arm of the Finnish prostate cancer screening trial during 1996–2004. Information on medication use was obtained from a comprehensive national prescription database. Cox proportional hazards regression was used to calculate multivariable adjusted hazard ratios (HRs) for prostate cancer. Serum prostate‐specific antigen (PSA) level was compared between current users and non‐users of cholesterol‐lowering drugs. Compared with medication non‐users, the overall prostate cancer incidence was decreased among statin users [HR 0.75, 95% confidence interval (CI) 0.63–0.89]. The inverse association was dose‐dependent with cumulative amount of statin use, and strongest for low‐grade and early stage tumors. The incidence was nonsignificantly lower also among users of other types of cholesterol‐lowering drugs (HR 0.62, 95% CI 0.28–1.38), but without dose‐dependence. Age‐adjusted median serum PSA tended to be lower among users of cholesterol‐lowering drugs, but the relative risk decrease among statin users was not related to decreased PSA. Overall incidence of prostate cancer was lowered among statin users when bias due to differential PSA testing between medication users and non‐users was eliminated by systematical prostate cancer screening. Cholesterol‐lowering with statins seems beneficial for prostate cancer prevention.