Continuation With Statin Therapy and the Risk of Primary Cancer: A Population-Based Study

Miriam Lutski, MSc; Varda Shalev, MD; Avi Porath, MD; Gabriel Chodick, PhD

Suggested citation for this article: Lutski M, Shalev V, Porath A, Chodick G. Continuation With Statin Therapy and the Risk of Primary Cancer: A Population-Based Study. Prev Chronic Dis 2012;9:120005. DOI: http://dx.doi.org/10.5888/pcd9.120005

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All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/pcd

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Release date: August 08, 2012; Expiration date: August 08, 2013

Learning Objectives

Upon completion of this activity, participants will be able to:

Assess the pleiotropic effects of statins
Distinguish the effect of statin therapy on the risk of incident cancer in the current study
Identify the type of cancer most inhibited by statins in the current study
Evaluate variables which might affect the efficacy of statins in preventing cancer

CME EDITOR
Teresa Ramsey, Editor; Camille Martin, Editor, Preventing Chronic Disease. Disclosures: Teresa Ramsey and Camille Martin disclosed no relevant financial relationships.
CME AUTHOR
Charles P. Vega, MD, Health Sciences Clinical Professor; Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.
AUTHORS AND CREDENTIALS
Disclosures: Miriam Lutski, MSc; Varda Shalev, MD; Avi Porath, MD; Gabriel Chodick, PhD have disclosed no relevant financial relationships.

Affiliations: Miriam Lutski, MSc, Sackler Faculty of Medicine, Tel Aviv University, Israel; Varda Shalev, MD, Sackler Faculty of Medicine, Tel Aviv University, Israel, and Maccabi Healthcare Services, Tel Aviv, Israel; Avi Porath, MD, Gabriel Chodick, PhD, Maccabi Healthcare Services, Tel Aviv, Israel

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Abstract

Introduction
Studies have suggested that statins may inhibit tumor cell growth and possibly prevent carcinogenesis. The objective of this study was to investigate the association between persistent statin use and the risk of primary cancer in adults.
Methods
This retrospective study was conducted by using the computerized data sets of a large health maintenance organization (HMO) in Israel. The study population was 202,648 enrollees aged 21 or older who purchased at least 1 pack of statin medication from 1998 to 2006. The follow-up period was from the date of first statin dispensation (index date) to the date of first cancer diagnosis, death, leaving the HMO, or September 1, 2007, whichever occurred first. Persistence was measured by calculating the mean proportion of follow-up days covered (PDC) with statins by dividing the quantity of statin dispensed by the total follow-up time.
Results
During the study period, 8,662 incident cancers were reported. In a multivariable model, the highest cancer risk was calculated among nonpersistent statin users. A strong negative association between persistence with statin therapy and cancer risk was calculated for hematopoietic malignancies, where patients covered with statins in 86% or more of the follow-up time had a 31% (95% confidence interval, 0.55-0.88) lower risk than patients in the lowest persistence level (≤12%).
Conclusion
Our study demonstrated that persistent use of statins is associated with a lower overall cancer risk and particularly the risk of incident hematopoietic malignancies. In light of widespread statin consumption and increases in cancer incidence, the association between statins and cancer incidence may be relevant for cancer prevention.