Weigh these five findings when considering statins for cancer prevention

Statins have long been at the forefront of lowering cholesterol and preventing CV events such as heart attack and stroke. Recent studies have also suggested that statin use may be associated with a lower risk for various types of cancers. However, cardiologists and oncologists caution the public against placing too much emphasis on these studies, which for the most part have been observational rather than prospective.

Nevertheless, some cardiologists have noted that the anti-inflammatory effects of statins could potentially have some benefit for preventing malignancies.

Cardiology Today has compiled a list of some factors to consider while sifting through the mountains of available information.

1. The liver might be particularly receptive to treatment with statins.

In a systematic review and meta-analysis, researchers concluded that statin users may be at reduced risk of developing hepatocellular carcinoma (HCC) vs. non-users.

The study included 4,298 cases of HCC among 1,459,417 patients eligible for review. The adjusted OR for HCC among statin users vs. non-users was 0.63 (95% CI, 0.52-0.76). According to William Sanchez, MD, of the departments of gastroenterology and hepatology at Mayo Clinic, these data are “inconclusive.” However, due to the uptake of statins by the liver, Marco Mielcarek, MD, associate member of the clinical research division at Fred Hutchinson Cancer Research Center and associate professor of medicine at the University of Washington, said the liver might be “a good organ to start with” when looking at cancer chemoprevention. Read more

2. When combined with NSAIDs or aspirin, statins may protect against esophageal cancer.

In a meta-analysis presented at the 2012 American College of Gastroenterology Annual Scientific Meeting, researchers reported that statin users were at a decreased risk of esophageal cancer. This risk reduction was particularly pronounced among those who had taken statins for a longer time, or who combined them with NSAIDs or aspirin. Read more

3. A Danish study indicated a 15% decrease in cancer-related mortality among statin users.

In a population-based study of 18,721 statin users and 277,204 never-users in Denmark, researchers found that the use of statins was linked to reduced all-cause mortality (HR=0.85; 95% CI, 0.83-0.87) and cancer-related mortality (HR=0.85; 95% CI, 0.82-0.87) vs. never-use. This association was observed across 13 cancer subtypes, with HRs ranging from 0.64 (95% CI, 0.46-0.88) for cervical cancer to 0.89 (95% CI, 0.81-0.98) for pancreatic cancer. However, some clinicians reasoned that statin users may be more health-conscious overall, which could contribute to a decreased mortality rate. Read more

4. In the JUPITER study, statin use was linked to decreased mortality and cancer occurrence.

The JUPITER study was the largest randomized, double blind, placebo-controlled trial of a statin, specifically rosuvastatin (Crestor, AstraZeneca). In this study of more than 17,600 patients, researchers found that rosuvastatin use decreased cancer mortality with no increase in cancer occurrence compared with placebo. However, study investigator Paul M. Ridker, MD, subsequently told Cardiology Today that he “[does] not believe there is reliable evidence showing that statin therapy increases or decreases the risk of cancer.” Read more

5. Statin and aspirin use have been linked to an 84% risk reduction for uterine cancer.

In a study presented at the 2013 American Society for Clinical Oncology (ASCO) annual meeting, researchers found that the use of statins and aspirin was linked to a mortality risk reduction of more than 80% among women with uterine malignancies.

Additionally, a retrospective cohort study presented at the 2012 San Antonio Breast Cancer Symposium reported that statin use was associated with improved disease-free and overall survival among 724 patients with primary breast cancer. However, some clinicians have noted that patients with poor-prognosis cancers would not likely be taking statins to prevent future heart disease, and that the patients receiving statins may have been healthier to begin with. Read more