Category: Professional Posters
Purpose: Prostate cancer is the most common cancer among men worldwide. Numerous epidemiologic studies have suggested an association between the risks of incident prostate cancer in men and the use of statins, the first-line and well tolerated lipid-lowering agents. However, the relevant conclusions are revealed controversial. In present study, we conducted a population-based propensity-matched cohort study using comprehensive information from Taiwan’s National Health Insurance Research Database (NHIRD), and attempted to investigate the association between statin use and the subsequent development of incident prostate cancer.
Methods: Taiwan’s NHIRD contains comprehensive information of clinical visits, including prescription details and diagnostic codes of all beneficiaries of the Taiwan National Health Insurance program, which covers nearly 99% of all Taiwanese residents. The eligible study population was categorized as statin user group and statin nonuser group. Statin users were defined as patients who had received at least one statin prescription during the study period (January 1, 2000 to December 31, 2011). Conversely, patients with at least one ambulatory care visit and no statin prescriptions during the study period were defined as statin nonusers. In addition, patients with a history of malignancy before the index date were excluded. We employed a 1:1 statin users–nonusers matching analysis based on age, propensity score, and index year. In accordance with Anatomic Therapeutic Chemical classification system code, we selected simvastatin, pravastatin, fluvastatin, atorvastatin, and rosuvastatin for analysis. Meanwhile, the characteristics of statins (potency, lipophilicity, and type) and the dose- and duration-response were also analyzed. The dissimilarities in the participant characteristics were assessed using the chi-square and t tests for categorical and continuous variables. Relationships between statin use and the risk of prostate cancer were evaluated using the Cox proportional hazards model.
Results: In the final 53,292 enrolled patients, statin-users revealed a trend of lower risk of incident prostate cancer as compared to non-statin users; incidence rates (IRs) are 8.29 and 9.76 cases per 1000 person-years in statin users and in non-statin users respectively (HR, 0.86; 95% CI, 0.72-1.03, p = 0.111). In the further subgroup analysis, patients with cumulative use of statins demonstrated significant lower risks for incident prostate cancer in dose- (301-600 DDDs: aHR = 0.60, 95% CI = 0.40-0.89, p <0.05; 601-900 DDDs: aHR = 0.42, 95% CI = 0.23-0.77, p <0.01; ≧901 DDDs: aHR = 0.21, 95% CI = 0.11-0.41, p < 0.001), and duration-dependent manners (601-1200 days: aHR = 0.59, 95% CI = 0.40-0.88, p <0.05; 1201-1800 days: aHR = 0.41, 95% CI = 0.23-0.74, p <0.01; ≧1801 days: aHR = 0.22, 95% CI = 0.10-0.47, p < 0.001). Furthermore, rosuvastatin (HR = 0.40, 95% CI = 0.22-0.72, p < 0.01) and hydrophilic statin users (HR = 0.70, 95% CI = 0.49-0.99, p < 0.05) also revealed lower risks for incident prostate cancer.
Conclusion: Our findings suggest that statin use was associated with the decrease risks of incident prostate cancer in manners of cumulative statin use and statin types.