筛查他汀类药物潜在的致癌风险：对361,859名接受者长达9年的随访

Screening statins for possible carcinogenic risk: up to 9 years of follow-up of 361,859 recipients.

作者信息

Friedman Gary D, Flick E Dawn, Udaltsova Natalia, Chan James, Quesenberry Charles P, Habel Laurel A

机构信息

Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Pharmacoepidemiol Drug Saf. 2008 Jan;17(1):27-36. doi: 10.1002/pds.1507.

DOI:10.1002/pds.1507

PMID:17944002

Abstract

PURPOSE

Determine the risk of cancer in statin users.

METHODS

Risk of cancer in up to 9.4 years after first recorded receipt of statins was evaluated in subscribers of an integrated health care program in northern California. Statin use and cancer development were ascertained from the program's pharmacy records and cancer registry from August 1994 to December 2003.

RESULTS

Most of the 361,859 statin users received lovastatin, simvastatin or both. Results are presented from analyses with 2-year lag and use for over 5 years. Most of the observed associations were likely due to chance or confounding. The few associations that seemed less readily explainable were increased risk of cancers of the thyroid, esophagus and urinary tract and decreased risk of colon cancer in men. Increased risk of lung cancer was the only nominally statistically significant positive association in women and could be partially attributable to their smoking habits.

CONCLUSIONS

Overall this study provided no strong evidence of either causation or prevention of cancer by statins.

摘要

目的

确定他汀类药物使用者患癌症的风险。

方法

在加利福尼亚州北部一个综合医疗保健项目的订阅者中，评估首次记录使用他汀类药物后长达9.4年的患癌风险。他汀类药物的使用情况和癌症发生情况是从该项目1994年8月至2003年12月的药房记录和癌症登记处确定的。

结果

361,859名他汀类药物使用者中，大多数使用洛伐他汀、辛伐他汀或两者都用。结果来自滞后2年且使用超过5年的分析。大多数观察到的关联可能是由于偶然或混杂因素。少数似乎不太容易解释的关联包括甲状腺癌、食管癌和泌尿系统癌症风险增加，以及男性结肠癌风险降低。肺癌风险增加是女性中唯一名义上具有统计学显著意义的正相关，这可能部分归因于她们的吸烟习惯。