Sackler Faculty of Medicine, Tel Aviv University, Israel.
Prev Chronic Dis. 2012;9:E137. doi: 10.5888/pcd9.120005.
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.
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.
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%).
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.
研究表明，他汀类药物可能抑制肿瘤细胞生长，并可能预防癌症发生。本研究旨在探讨长期使用他汀类药物与成年人原发性癌症风险之间的关系。
本回顾性研究使用了以色列一家大型健康维护组织（HMO）的计算机化数据集。研究人群为 202648 名年龄在 21 岁及以上的参保者，他们在 1998 年至 2006 年间至少购买过 1 盒他汀类药物。随访期从首次开具他汀类药物处方（索引日期）至首次癌症诊断、死亡、离开 HMO 或 2007 年 9 月 1 日（以先发生者为准）。通过计算用他汀类药物覆盖的随访天数比例（PDC）来衡量持续性，即所开他汀类药物的数量除以总随访时间。
在研究期间，报告了 8662 例新发癌症。在多变量模型中，非持续性他汀类药物使用者的癌症风险最高。他汀类药物治疗的持续性与癌症风险之间存在很强的负相关关系，尤其是在血液恶性肿瘤中，在 86%或更高的随访时间内用他汀类药物覆盖的患者的风险比最低持续性水平（≤12%）的患者低 31%（95%置信区间，0.55-0.88）。
本研究表明，长期使用他汀类药物与总体癌症风险降低相关，尤其是与新发血液恶性肿瘤风险降低相关。鉴于他汀类药物的广泛使用和癌症发病率的增加，他汀类药物与癌症发病率之间的关联可能与癌症预防有关。
