Asgari Maryam M, Tang Jean, Epstein Ervin H, Chren Mary-Margaret, Warton E Margaret, Quesenberry Charles P, Go Alan S, Friedman Gary D
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
J Am Acad Dermatol. 2009 Jul;61(1):66-72. doi: 10.1016/j.jaad.2009.02.011. Epub 2009 May 21.
We examined the association between statin use and basal cell carcinoma (BCC) risk.
We identified all members of a large integrated health care delivery system with a diagnosis of a histologically proven BCC in 1997. Subsequent BCCs were identified through 2006 from health plan electronic pathology records. Longitudinal exposure to statins and other lipid-lowering agents was determined from automated pharmacy records. We used extended Cox regression to examine the independent association between receipt of statin therapy (ever vs never, cumulative duration) and risk of subsequent BCC. To minimize confounding by indication, we conducted sensitivity analyses in the subset of individuals considered eligible for lipid-lowering therapy based on national guidelines.
Among 12,123 members given a diagnosis of BCC who had no prior statin exposure, 6381 developed a subsequent BCC during follow-up. Neither "ever use of statins" (adjusted hazard ratio 1.02, 95% confidence interval: 0.92-1.12) or cumulative duration of statin (adjusted hazard ratio 1.02/year, 95% confidence interval: 0.99-1.11) was associated with subsequent BCC after adjustment for age, sex, and health care use. Risk estimates did not change appreciably when the analysis was limited to the subset of individuals who met eligibility criteria for initiating statin therapy. There was also no significant association between use of non-statin antilipemics and subsequent BCC (adjusted hazard ratio 1.10, 95% confidence interval: 0.76-1.58).
No information was available for BCC risk factors, such as sun sensitivity and sun exposure.
Among a large cohort of individuals with BCC, statin therapy was not significantly associated with risk of subsequent BCC.
我们研究了他汀类药物使用与基底细胞癌(BCC)风险之间的关联。
我们确定了一个大型综合医疗保健系统中所有在1997年被诊断为经组织学证实的基底细胞癌的成员。通过健康计划电子病理记录确定了2006年之前的后续基底细胞癌病例。从自动化药房记录中确定他汀类药物和其他降脂药物的纵向暴露情况。我们使用扩展的Cox回归来研究接受他汀类药物治疗(曾经使用与从未使用、累积持续时间)与后续基底细胞癌风险之间的独立关联。为了尽量减少适应证造成的混杂因素,我们在根据国家指南被认为适合降脂治疗的个体子集中进行了敏感性分析。
在12123名被诊断为基底细胞癌且之前未接触过他汀类药物的成员中,6381人在随访期间出现了后续基底细胞癌。在对年龄、性别和医疗保健使用情况进行调整后,“曾经使用他汀类药物”(调整后的风险比为1.02,95%置信区间:0.92 - 1.12)或他汀类药物的累积持续时间(调整后的风险比为每年1.02,95%置信区间:0.99 - 1.11)均与后续基底细胞癌无关。当分析仅限于符合启动他汀类药物治疗资格标准的个体子集时,风险估计值没有明显变化。使用非他汀类降脂药与后续基底细胞癌之间也没有显著关联(调整后的风险比为1.10,95%置信区间:0.76 - 1.58)。
无法获得基底细胞癌风险因素的信息,如日光敏感性和日晒情况。
在一大群基底细胞癌患者中,他汀类药物治疗与后续基底细胞癌风险无显著关联。