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利用韩国国家健康保险索赔数据库评估他汀类药物与肾癌发病和死亡风险的相关性。

Association Between Statins and the Risk of Kidney Cancer Incidence and Mortality Using the Korean National Health Insurance Claims Database.

机构信息

65558Health Insurance Review and Assessment Service, Wonju, South Korea.

Department of Preventive Medicine, College of Medicine, 34973Korea University, Seoul, South Korea.

出版信息

Cancer Control. 2022 Jan-Dec;29:10732748221111293. doi: 10.1177/10732748221111293.

Abstract

BACKGROUND

Conflicting results have been reported regarding the potential preventive effects of statins on the risk of cancer. This study investigated the associations of statin use with the incidence and mortality of kidney cancer in South Korea.

METHODS

In this retrospective population-based cohort study using the National Health Insurance claims database, we compared patients aged 45-70 years who had used statins for at least 6 months to non-statin users matched by age and sex from 2005 to June 2013. The main outcomes were kidney cancer incidence and mortality according to statin use. Cox proportional hazard regression was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs).

RESULTS

In the cohort of 1 008 101 people, the aHRs for the association between statin use and the outcomes were .84 (95% CI: 0.71-.99) for kidney cancer incidence and .65 (95% CI: 0.41-.98) for kidney cancer mortality. In the matched cohort of 337 578, the risk per 1000 people of cancer incidence and mortality was 1.63, 1.07, and .24, .17 in statin users and non-users, respectively. In matched cohort, the risk of kidney cancer incidence and mortality decreased, but it is not statistically significant. Also, there was no linear relationship with increased doses.

CONCLUSION

Statin use might be associated with a decreased risk of kidney cancer incidence and mortality, but it showed no statistical significance. This study was a large-scale analysis, however, further studies that are larger and multinational in scope are needed to confirm the beneficial effects of statins on survival.

摘要

背景

关于他汀类药物预防癌症风险的潜在作用,已有相互矛盾的结果报告。本研究调查了他汀类药物的使用与韩国肾癌发病率和死亡率的关系。

方法

本研究使用国家健康保险索赔数据库,对 2005 年至 2013 年 6 月期间至少使用他汀类药物 6 个月的年龄在 45-70 岁之间的患者与年龄和性别相匹配的非他汀类药物使用者进行了回顾性基于人群的队列研究。主要结局是根据他汀类药物的使用情况评估肾癌的发病率和死亡率。使用 Cox 比例风险回归计算调整后的危险比(aHR)和 95%置信区间(95%CI)。

结果

在 1008101 人的队列中,他汀类药物使用与结局之间的关联的 aHR 为 0.84(95%CI:0.71-0.99),肾癌发病率为 0.65(95%CI:0.41-0.98)。在 337578 人的匹配队列中,每 1000 人癌症发病率和死亡率的风险分别为 1.63、1.07 和 0.24、0.17,在他汀类药物使用者和非使用者中。在匹配队列中,肾癌发病率和死亡率的风险降低,但无统计学意义。此外,与剂量增加之间没有线性关系。

结论

他汀类药物的使用可能与肾癌发病率和死亡率降低有关,但无统计学意义。本研究是一项大规模分析,但需要更大规模和跨国范围的进一步研究来证实他汀类药物对生存的有益影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5df1/9393673/63f4318fb1d4/10.1177_10732748221111293-fig1.jpg

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