Cardwell Chris R, Spence Andrew D, Hughes Carmel M, Murray Liam J
Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
Cancer Epidemiol. 2017 Jun;48:124-130. doi: 10.1016/j.canep.2017.04.015. Epub 2017 May 6.
A recent epidemiological study of esophageal cancer patients concluded statin use post-diagnosis was associated with large (38%) and significant reductions in cancer-specific mortality. We investigated statin use and cancer-specific mortality in a large population-based cohort of esophageal cancer patients.
Newly diagnosed [2009-2012] esophageal cancer patients were identified from the Scottish Cancer Registry and linked with the Prescribing Information System and Scotland Death Records (to January 2015). Time-dependent Cox regression models were used to calculate hazard ratios (HR) for cancer-specific mortality and 95% confidence intervals (CIs) by post-diagnostic statin use (using a 6 month lag to reduce reverse causation) and to adjust these HRs for potential confounders.
1921 esophageal cancer patients were included in the main analysis, of whom 651 (34%) used statins after diagnosis. There was little evidence of a reduction in esophageal cancer-specific mortality in statin users compared with non-users after diagnosis (adjusted HR=0.93, 95% CI, 0.81, 1.07) and no dose response associations were seen. However, statin users compared with non-users in the year before diagnosis had a weak reduction in esophageal cancer-specific mortality (adjusted HR=0.88, 95% CI, 0.79, 0.99).
In this large population-based esophageal cancer cohort, there was little evidence of a reduction in esophageal cancer-specific mortality with statin use after diagnosis.
最近一项针对食管癌患者的流行病学研究得出结论，诊断后使用他汀类药物与癌症特异性死亡率大幅（38%）且显著降低相关。我们在一个基于人群的大型食管癌患者队列中调查了他汀类药物的使用情况和癌症特异性死亡率。
从苏格兰癌症登记处识别出2009年至2012年新诊断的食管癌患者，并将其与处方信息系统和苏格兰死亡记录（至2015年1月）相链接。使用时间依赖性Cox回归模型，通过诊断后他汀类药物的使用情况（采用6个月的滞后时间以减少反向因果关系）计算癌症特异性死亡率的风险比（HR）和95%置信区间（CI），并对这些HR进行潜在混杂因素的调整。
1921例食管癌患者纳入主要分析，其中651例（34%）在诊断后使用他汀类药物。诊断后，与未使用者相比，他汀类药物使用者的食管癌特异性死亡率几乎没有降低的迹象（调整后的HR = 0.93，95%CI为0.81至1.07），且未观察到剂量反应关联。然而，与诊断前一年的未使用者相比，可以看到他汀类药物使用者的食管癌特异性死亡率略有降低（调整后的HR = 0.88，95%CI为0.79至0.99）。
在这个基于人群的大型食管癌队列中，几乎没有证据表明诊断后使用他汀类药物可降低食管癌特异性死亡率。
