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Statin use, high cholesterol and prostate cancer progression; results from HCaP‐NC
Author(s) -
Allott Emma H.,
Farnan Laura,
Steck Susan E.,
Song Lixin,
Arab Lenore,
Su L. Joseph,
Fontham Elizabeth T. H.,
Mohler James L.,
Bensen Jeannette T.
Publication year - 2018
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.23644
Subject(s) - medicine , prostate cancer , statin , cancer , cohort , oncology , proportional hazards model , population , prostate , cohort study , gynecology , environmental health
Background Statin use is associated with lower advanced prostate cancer risk and reduced prostate cancer‐specific mortality, but prior studies were conducted mainly in white men. We examined the effect of statin use on risk of prostate cancer progression in a population‐based, minority‐enriched cohort. Methods We used data from prostate cancer cases (45% African American) diagnosed between 2004 and 2007 who participated in the Health Care Access and Prostate Cancer Treatment in North Carolina cohort (HCaP‐NC). We abstracted statin use at diagnosis. Men reported if they had ever been diagnosed with high cholesterol. Multivariable Cox proportional hazards analysis was used to examine associations between statin use and risk of prostate cancer progression (biochemical recurrence or secondary treatment), overall and by race. In secondary analysis, we examined the association between high cholesterol and risk of progression, overall, and by statin use. Results Of 669 men, 244 (36%) were statin users at diagnosis. During 3.8 years median follow‐up, 138 men experienced prostate cancer progression. There was no association between statin use and risk of progression, either overall (HR 1.03; 95%CI 0.72‐1.46) or stratified by race. High cholesterol was inversely associated with risk of progression, particularly among statin users (HR 0.43; 95%CI 0.20‐0.94; p‐interaction = 0.22) and in men with higher perceived access to care (HR 0.57; 95%CI 0.36‐0.90; p‐interaction = 0.03). Study limitations included a relatively small sample size, short follow‐up, and lack of data regarding post diagnosis statin use. Conclusions Statin use at diagnosis was not associated with prostate cancer progression in the population‐based, minority‐enriched HCaP‐NC. Greater healthcare engagement, including actively controlling serum cholesterol, may be linked to better prostate cancer‐specific outcomes.