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Statin use and risk of prostate cancer: Results from the Southern Community Cohort Study
Author(s) -
Kantor Elizabeth D.,
Lipworth Loren,
Fowke Jay H.,
Giovannucci Edward L.,
Mucci Lorelei A.,
Signorello Lisa B.
Publication year - 2015
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23019
Subject(s) - medicine , prostate cancer , hazard ratio , statin , cancer , confidence interval , oncology , cohort , proportional hazards model , cohort study , prostate specific antigen , prostate , gynecology
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. Prostate 75:1384–1393, 2015 . © 2015 Wiley Periodicals, Inc.