Guideline-Based Statin Eligibility and Cancer Risk

Key Points

  • Statin-eligible participants were at higher risk of incident cancer and cancer mortality.
  • These participants were at increased risk of noncardiovascular-related mortality.

A study in the offspring and third-generation cohorts of the Framingham Heart Study showed that eligibility for statin therapy was associated with an increased risk for cancer and cancer mortality. These findings were reported by Pursnani et al in the Journal of Clinical Oncology.

Study Details

The study included 2,196 participants (mean age = 50.5 years, 55% female) who were statin-naive and free of cancer at baseline. Statin eligibility was determined according to the 2013 American College of Cardiology/American Heart Association guidelines. The primary outcome was incident cancer at a median of 10.0 years (interquartile range = 9.1–10.6 years) of follow-up.

Risk of Cancer

The incident cancer rate was 11.2% (247 of 2,196), with 58 noncardiovascular deaths occurring, including 39 cancer deaths (1.8%). Overall, 37% of the cohort (812 of 2,196) were statin-eligible. Incident cancer occurred in 125 of the statin-eligible participants (15%) vs 122 of the statin-noneligible participants (8.8%; subdistribution hazard ratio [HR] = 1.8, 95% confidence interval [CI] = 1.4–2.3, P < .001). Cancer mortality occurred in 34 of the statin-eligible participants (4.2%) vs 5 of the noneligible participants (0.4%; subdistribution HR = 12.1, 95% CI = 4.7–31, P < .001). Noncardiovascular mortality occurred in 49 of the statin-eligible participants (6.0%) vs 9 of the noneligible participants (0.7%; subdistribution HR = 10.1, 95% CI = 5.0–21, P < .001). In stratified analyses, these findings were independent of individual risk factors such as body mass index, age, and smoking status.

The investigators concluded: “In this community-based primary prevention cohort, guideline-based statin eligibility accurately identified patients at a higher risk of developing cancer and cancer-related mortality. Shared risk profiles and potential benefits of statins between cancer and cardiovascular outcomes may provide a unique opportunity to improve population health.”

The study was supported by the National Institutes of Health Heart, Lung, and Blood Institute’s Framingham Heart Study.

Amit Pursnani, MD, of NorthShore University HealthSystem, Evanston, Illlinois, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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