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长期使用降胆固醇药物与美国大型队列人群癌症发病风险。

Long-term use of cholesterol-lowering drugs and cancer incidence in a large United States cohort.

机构信息

Epidemiology Research Program, American Cancer Society, National Home Office, Atlanta, Georgia 30303-1002, USA.

出版信息

Cancer Res. 2011 Mar 1;71(5):1763-71. doi: 10.1158/0008-5472.CAN-10-2953. Epub 2011 Feb 22.

DOI:10.1158/0008-5472.CAN-10-2953
PMID:21343395
Abstract

HMG-coA reductase inhibitors, commonly known as statins, account for the great majority of cholesterol-lowering drug use. However, little is known about the association between long-term statin use and incidence of most types of cancers. We examined the association between long-term use of cholesterol-lowering drugs, predominantly statins, and the incidence of ten common cancers, as well as overall cancer incidence, among 133,255 participants (60,059 men and 73,196 women) in the Cancer Prevention Study II Nutrition Cohort during the period from 1997 to 2007. Multivariate Cox proportional hazards regression was used to estimate relative risks (RR). Current use status and duration of use were updated during follow-up using information from biennial follow-up questionnaires. Current use of cholesterol-lowering drugs for five or more years was not associated with overall cancer incidence (RR = 0.97, 95% CI = 0.92-1.03), or incidence of prostate, breast, colorectal, lung, bladder, renal cell, or pancreatic cancer but was associated with lower risk of melanoma (RR = 0.79, 95% CI = 0.66-0.96), endometrial cancer (RR = 0.65, 95% CI = 0.45-0.94), and non-Hodgkin lymphoma (NHL; RR = 0.74, 95% CI = 0.62-0.89). These results suggest that long-term use of statins is unlikely to substantially increase or decrease overall cancer risk. However, associations between long-term statin use and risk of endometrial cancer, melanoma, and NHL deserve further investigation.

摘要

羟甲基戊二酰辅酶 A 还原酶抑制剂,通常被称为他汀类药物,是降胆固醇药物的主要用药。然而,人们对长期使用他汀类药物与大多数类型癌症的发病率之间的关系知之甚少。我们研究了降脂药物(主要是他汀类药物)的长期使用与 133255 名参与者(60059 名男性和 73196 名女性)中 10 种常见癌症以及总体癌症发病率之间的关系,这些参与者来自癌症预防研究 II 营养队列,随访时间为 1997 年至 2007 年。使用多变量 Cox 比例风险回归来估计相对风险(RR)。在随访期间,使用来自每两年一次的随访问卷中的信息更新当前使用状态和使用持续时间。降脂药物的当前使用状态(使用时间≥5 年)与总体癌症发病率(RR=0.97,95%CI=0.92-1.03)或前列腺癌、乳腺癌、结直肠癌、肺癌、膀胱癌、肾癌或胰腺癌的发病率无关,但与黑色素瘤(RR=0.79,95%CI=0.66-0.96)、子宫内膜癌(RR=0.65,95%CI=0.45-0.94)和非霍奇金淋巴瘤(NHL;RR=0.74,95%CI=0.62-0.89)的风险降低相关。这些结果表明,长期使用他汀类药物不太可能显著增加或降低总体癌症风险。然而,长期使用他汀类药物与子宫内膜癌、黑色素瘤和 NHL 风险之间的关联值得进一步研究。

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