Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.
Department of Global Education, Harvard Medical School, Boston, MA.
Int J Cancer. 2019 Mar 1;144(5):991-1000. doi: 10.1002/ijc.31758. Epub 2018 Oct 30.
Statins are widely used to lower blood cholesterol and reduce risk for cardiovascular diseases, but attention has recently focused on a role in cancer prevention or therapy. Here we present data from a large case-control study addressing whether statin use can lower the risk for epithelial ovarian cancer (EOC). Between 1992 and 2008, data including medications used for at least 6 months were collected from 2,040 cases with EOC and 2,100 frequency-matched controls without the disease who participated in the New England Case Control study. We used unconditional logistic regression controlling for matching factors and potential confounders to examine the association between statin use and the risk for EOC. Overall, women who used statins had 32% lower risk of ovarian cancer compared to non-users (Odds ratio (OR) 0.68, 95% Confidence Interval (CI): 0.54-0.85), adjusting for the matching factors and other covariates. The reduced risk was most apparent in women taking a lipophilic statin who began use after age 49, and who had used them 2-4.9 years. Statin use was associated with lower risks for both serous and non-serous histologic subtypes with the strongest effect seen for mucinous and mixed epithelial subtypes. The association became apparent about a decade after the introduction of statins and did not appear to be confounded by indications for use of statins or medications used concomitantly. In this case-control study, statins were found to lower the risk for both serous and non-serous EOC and especially mucinous EOC.
他汀类药物被广泛用于降低血液胆固醇水平，降低心血管疾病的风险，但最近人们关注的焦点是其在癌症预防或治疗中的作用。在这里，我们呈现了一项大型病例对照研究的数据，该研究旨在探讨他汀类药物的使用是否可以降低上皮性卵巢癌（EOC）的风险。在 1992 年至 2008 年期间，我们从参加新英格兰病例对照研究的 2040 名 EOC 患者和 2100 名无该病的频率匹配对照者中收集了至少使用 6 个月的药物数据。我们使用非条件逻辑回归控制匹配因素和潜在混杂因素，以检验他汀类药物使用与 EOC 风险之间的关联。总体而言，与未使用者相比，使用他汀类药物的女性卵巢癌风险降低了 32%（优势比（OR）为 0.68，95%置信区间（CI）为 0.54-0.85），调整了匹配因素和其他协变量。在 49 岁以后开始使用亲脂性他汀类药物、使用时间为 2-4.9 年的女性中，这种风险降低最为明显。他汀类药物的使用与浆液性和非浆液性组织学亚型的风险降低均相关，其中以黏液性和混合上皮亚型的效果最为显著。这种关联在他汀类药物问世约十年后才显现出来，而且似乎不受他汀类药物使用指征或同时使用的药物的混杂影响。在这项病例对照研究中，他汀类药物被发现可降低浆液性和非浆液性 EOC 的风险，尤其是黏液性 EOC 的风险。
