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Statins associated with reduced risk for total, high-grade prostate cancer
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A review of data collected on more than 55,000 men showed that those assigned to a statin were 30% less likely to be diagnosed with prostate cancer and 60% less likely to be diagnosed with high-grade disease compared with men assigned to antihypertensive medication.
In results presented at the Innovative Minds in Prostate Cancer Today conference, researchers said the data suggest that statins, a class of drug used to lower cholesterol levels by inhibiting gonadotropin-releasing hormone, may prevent prostate cancer.
“We are now sure that clinical trials of statins for prostate cancer prevention are warranted,” Wildon Farwell, MD, an internist with Brigham and Women’s Hospital, said in a press release. Farrell was a researcher on the study.
Researchers identified 55,875 men assigned to either a statin or antihypertensive medication using electronic and administrative files collected at the VA New England Healthcare System.
Overall, they found that statin users were 30% less likely to be diagnosed with prostate cancer (HR=0.7; 95% CI, 0.53-0.91). Statin users were also 13% less likely to be diagnosed with low-grade disease (HR=0.87; 95% CI, 0.63-1.21) and 60% less likely to be diagnosed with high-grade disease (HR=0.4; 95% CI, 0.25-0.65).
Researchers concluded that total cholesterol level was predictive for both total prostate cancer incidence (HR=1.02; 95% CI, 1-1.05) and incidence of high-grade disease (HR=1.06; 95% CI, 1.02-1.1). Total cholesterol was not predictive for incidence of low-grade disease (HR=1.01; 95% CI, 0.98-1.04).
“Although prostate cancer is commonly diagnosed, few risk factors for high-grade prostate cancer are known and few prevention strategies exist,” Farwell said. “Learning more about the relationship between statins and prostate cancer may provide important clues into the basic biology of prostate cancer.”
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These results are very promising. Similar studies show that statins reduce risk for colon cancer. But, the weakness with these reports is that they come from epidemiologic-type studies. While we can get important leads from such observational studies regarding the efficacy of drugs like statins in a chemopreventive setting, to get definitive answers we need properly designed clinical trials. For example, a national, randomized, prospective, trial, the P5 study, of a statin (rosuvastatin) is now being conducted to determine the effectiveness of this drug for the prevention of colon cancer. The P5 study started in 2010 and is being conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP) under the auspices of the NCI. Although the finding of a lower risk for prostate cancer among statin users is therefore very exciting, it does not, in my opinion, provide sufficient evidence to recommend that men start taking statins for prostate cancer prevention at this time.
– Bruce Boman, MD, PhD
Director of Cancer Genetics,
Helen F. Graham Cancer Center's Hereditary Cancer Risk Assessment Program
Disclosure: Dr. Boman reported no relevant disclosures.
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