Papagiannakis Alkiviadis, Kwiatkowski Maciej, Wyler Stephen F, Mortezavi Ashkan, Manka Lukas, Wettstein Marian S, Grobholz Rainer, Hammerer-Lercher Angelika, Eberli Daniel, Prause Lukas Werner
Department of Urology, Cantonal Hospital Aarau, Aarau, Switzerland.
Member of Medical Faculty, University of Basel, Basel, Switzerland.
Cancer Med. 2025 Jan;14(1):e70485. doi: 10.1002/cam4.70485.
While statins have demonstrated a variety of antineoplastic effects in preclinical studies, several retrospective clinical studies and observational studies have not shown a consistent chemopreventive benefit against prostate cancer (PCa). Therefore, in this population-based cohort study, we examined the association of statin intake on prostate specific antigen (PSA) values and risk of development of PCa.
N = 4,314 men from the Swiss section of the European Randomized Study of Screening for Prostate Cancer (ERSPC) were evaluated. N = 761 men were statin users [Stat+]. The median follow-up was 9.6 years. A transrectal prostate biopsy was performed in men with a PSA-level ≥ 3 ng/mL. Mortality and incidence data was obtained through registry linkages. PCa incidence, total serum PSA level, free-to-total PSA level, and overall survival were compared between [Stat+] and [Stat-] patients.
Total PSA values were significantly lower in [Stat+] patients at baseline (1.5 vs. 1.8 ng/mL, p < 0.001) and at last follow-up (1.8 vs. 2.1 ng/mL, p < 0.001). PCa detection during the follow-up period was significantly associated with baseline PSA. The overall incidence of PCa showed no statistical difference among [Stat+] and [Stat-] groups (7.4% vs. 9.5%, p = 0.08), indicating that statin use had no effect on the risk of developing PCa during follow-up. [Stat+] patients had a significantly higher overall mortality risk compared to [Stat-] patients (HR 2.04, p < 0.001).
A significant risk reduction in the development of PCa in [Stat+] patients was not found. We did observe lower PSA values among [Stat+] patients, compared to [Stat-] patients, with an increasing difference during follow-up.
虽然他汀类药物在临床前研究中已显示出多种抗肿瘤作用，但多项回顾性临床研究和观察性研究并未表明其对前列腺癌（PCa）具有一致的化学预防益处。因此，在这项基于人群的队列研究中，我们研究了他汀类药物摄入与前列腺特异性抗原（PSA）值及PCa发生风险之间的关联。
对来自欧洲前列腺癌筛查随机研究（ERSPC）瑞士部分的4314名男性进行了评估。761名男性为他汀类药物使用者[Stat+]。中位随访时间为9.6年。对PSA水平≥3 ng/mL的男性进行经直肠前列腺活检。通过登记链接获取死亡率和发病率数据。比较了[Stat+]和[Stat-]患者之间的PCa发病率、总血清PSA水平、游离PSA与总PSA水平以及总生存率。
[Stat+]患者在基线时（1.5 vs. 1.8 ng/mL，p < 0.001）和最后随访时（1.8 vs. 2.1 ng/mL，p < 0.001）的总PSA值显著更低。随访期间PCa检测与基线PSA显著相关。PCa的总体发病率在[Stat+]和[Stat-]组之间无统计学差异（7.4% vs. 9.5%，p = 0.08），表明使用他汀类药物对随访期间PCa发生风险无影响。与[Stat-]患者相比，[Stat+]患者的总体死亡风险显著更高（HR 2.04，p < 0.001）。
未发现[Stat+]患者PCa发生风险显著降低。与[Stat-]患者相比，我们确实观察到[Stat+]患者的PSA值更低，且随访期间差异增大。
