Post-diagnostic statin use and the risk of lethal prostate cancer in the Health Professionals Follow-up Study
A partir des données de la cohorte "Health Professionals Follow-Up Study" incluant 3 949 patients atteints d'un cancer de la prostate, cette étude évalue l'association entre l'utilisation de statines après le diagnostic et la mortalité spécifique (242 décès)
Background: Observational studies suggest potential chemopreventive benefits of statins on prostate cancer outcomes, but data on the impact of post-diagnostic use are sparse. Methods: We examined the association of post-diagnostic statin use and risk of lethal prostate cancer (metastases or prostate cancer death, N=242) among 3,949 men diagnosed with localized prostate cancer from the Health Professionals Follow-Up Study between 1992 and 2008 and followed through 2010 (33,302 person years). We used Cox proportional hazards regression models to estimate relative risks and 95% confidence intervals, adjusting for age, time period, time from diagnosis to questionnaire, body mass index, vigorous physical activity, smoking, aspirin use, clinical stage, PSA at diagnosis, Gleason score, primary treatment, and comorbidities. Results: We found no statistically significant association between post-diagnostic current use of statins or duration of statin usage and the outcome of lethal prostate cancer (N=242 cases; multivariate HR=0.97 (95% CI 0.72, 1.31) for current use yes/no; HR = 0.85 (95% CI 0.59, 1.22) for 1-5 years use, 0.96 (95% CI 0.66, 1.38) for 6+ years of use vs. never use). Conclusions: We observed little evidence that statin usage after diagnosis of localized prostate cancer reduces risk of progression to metastatic disease or prostate cancer specific death. Impact: These results do not support statins as a chemopreventive agent for prostate cancer progression.