TY - JOUR
T1 - Statin Use and Prostate Cancer Aggressiveness; Results from the Population-Based North Carolina-Louisiana Prostate Cancer Project
AU - Allott, Emma H
AU - Farnan, Laura
AU - Steck, Susan E
AU - Arab, Lenore
AU - Su, L Joseph
AU - Mishel, Merle
AU - Fontham, Elizabeth T H
AU - Mohler, James L
AU - Bensen, Jeannette T
N1 - ©2016 American Association for Cancer Research.
PY - 2016/4
Y1 - 2016/4
N2 - BACKGROUND: Although statin use has been associated with reduced prostate cancer aggressiveness, the impact of race and patient characteristics on this association is not well understood. We examined the association between statin use and prostate cancer aggressiveness in Caucasians (CA) and African Americans (AA) and explored effect modification by health-seeking behaviors associated with statin use.METHODS: Of 1,930 cases from The North Carolina-Louisiana Prostate Cancer Project, 344 (18%) were classified as aggressive based on clinical criteria. Utilizing nonaggressive cases as referent, logistic regression was used to examine the association between statin use and prostate cancer aggressiveness, overall and stratified by race. Smoking and prostate cancer screening were examined as effect modifiers of this association.RESULTS: There was an inverse association between statin use and prostate cancer aggressiveness [OR, 0.74; 95% confidence interval (CI), 0.56-0.96], with comparable effect estimates in both races. Although not statistically significant, statin use was associated with reduced ORs for aggressive prostate cancer in never-screened men (OR, 0.79; 95% CI, 0.45-1.39), men screened at low/recommended frequency (≤once/year; OR, 0.66; 95% CI, 0.41-1.06), and men screened at high frequency (>once/year; OR, 0.78; 95% CI, 0.53-1.15). Inverse associations between statins and aggressive prostate cancer were strongest in never smokers (OR, 0.42; 95% CI, 0.25-0.72), attenuated in former smokers (OR, 0.84; 95% CI, 0.59-1.19), and absent in current smokers (OR, 1.36; 95% CI, 0.70-2.64).CONCLUSIONS: Statin use was associated with reduced prostate cancer aggressiveness in CA and AAs, with strongest inverse associations in nonsmokers.IMPACT: Health-seeking behaviors associated with statin use should be considered when examining the impact of statins on prostate cancer aggressiveness.
AB - BACKGROUND: Although statin use has been associated with reduced prostate cancer aggressiveness, the impact of race and patient characteristics on this association is not well understood. We examined the association between statin use and prostate cancer aggressiveness in Caucasians (CA) and African Americans (AA) and explored effect modification by health-seeking behaviors associated with statin use.METHODS: Of 1,930 cases from The North Carolina-Louisiana Prostate Cancer Project, 344 (18%) were classified as aggressive based on clinical criteria. Utilizing nonaggressive cases as referent, logistic regression was used to examine the association between statin use and prostate cancer aggressiveness, overall and stratified by race. Smoking and prostate cancer screening were examined as effect modifiers of this association.RESULTS: There was an inverse association between statin use and prostate cancer aggressiveness [OR, 0.74; 95% confidence interval (CI), 0.56-0.96], with comparable effect estimates in both races. Although not statistically significant, statin use was associated with reduced ORs for aggressive prostate cancer in never-screened men (OR, 0.79; 95% CI, 0.45-1.39), men screened at low/recommended frequency (≤once/year; OR, 0.66; 95% CI, 0.41-1.06), and men screened at high frequency (>once/year; OR, 0.78; 95% CI, 0.53-1.15). Inverse associations between statins and aggressive prostate cancer were strongest in never smokers (OR, 0.42; 95% CI, 0.25-0.72), attenuated in former smokers (OR, 0.84; 95% CI, 0.59-1.19), and absent in current smokers (OR, 1.36; 95% CI, 0.70-2.64).CONCLUSIONS: Statin use was associated with reduced prostate cancer aggressiveness in CA and AAs, with strongest inverse associations in nonsmokers.IMPACT: Health-seeking behaviors associated with statin use should be considered when examining the impact of statins on prostate cancer aggressiveness.
KW - Humans
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
KW - Louisiana
KW - Male
KW - Middle Aged
KW - North Carolina
KW - Prostatic Neoplasms/prevention & control
KW - Treatment Outcome
KW - United States
U2 - 10.1158/1055-9965.EPI-15-0631
DO - 10.1158/1055-9965.EPI-15-0631
M3 - Article
C2 - 26819265
SN - 1055-9965
VL - 25
SP - 670
EP - 677
JO - Cancer Epidemiology Biomarkers & Prevention
JF - Cancer Epidemiology Biomarkers & Prevention
IS - 4
ER -