Long-Term Use of Statins May Reduce Risk of Lung Cancer Death
A large population-based British study of newly diagnosed patients with lung cancer has found that those who had prolonged use of statins, especially simvastatin, had a 19% reduction in lung cancer deaths. Among all patients, those who used statins in the year before their lung cancer diagnosis had a statistically significant 12% reduction in death from lung cancer. If confirmed in observational studies, a randomized trial of simvastatin as adjuvant cancer therapy in patients with lung cancer may be warranted. The study, by Cardwell et al, is published in Cancer Epidemiology, Biomarkers & Prevention.
Study Methodology
The researchers analyzed data from nearly 14,000 newly diagnosed patients with lung cancer between 1998 and 2009 from English cancer registry data. The patients’ prescription records were obtained from the U.K. Clinical Practice Research Datalink. The mortality data up to 2012 was obtained from the Office of National Statistics.
In the main analysis of statins after diagnosis, the exposure window for statin use was from lung cancer diagnosis to death or end of the follow-up, but was subject to a lag.
In the main analysis of statins before diagnosis, the exposure window was from 1 year before lung cancer diagnosis to the date of lung cancer diagnosis. Statins were analyzed individually and grouped by type into liphophilic statins, including simvastatin, fluvastatin, and cerivastatin (Baycol); and hydrophilic statins, including atorvastatin, pravastatin, and rosuvastatin.
Study Findings
In 3,638 patients with lung cancer, there was some evidence that statin use after diagnosis was associated with reduced lung cancer–specific mortality (adjusted hazard ratio [HR] = 0.89; 95% confidence interval [CI] = 0.78–1.02; P = .09). Associations were more marked after 12 prescriptions (adjusted HR = 0.81; 95% CI = 0.67–0.98; P = .03) and when lipophilic statins were investigated (adjusted HR = 0.81; 95% CI = 0.70–0.94; P = .01) but were attenuated in some sensitivity analyses.
In addition, in 11,051 patients, statin use before diagnosis was associated with reduced lung cancer–specific mortality (adjusted HR = 0.88; 95% CI = 0.83–0.93; P <.001).
The outcomes were not different between the patients with non–small cell lung cancer and those with small cell lung cancer.
“Our study provides some evidence that lung cancer patients who used statins had a reduction in the risk of death from lung cancer,” said Chris R. Cardwell, PhD, a senior lecturer in medical statistics at the Centre for Public Health at Queen’s University Belfast, Royal Victoria Hospital in Northern Ireland, in a statement.
“The magnitude of the association was relatively small and, as with all observational studies, there is the possibility of confounding—meaning that simvastatin users may have differed from simvastatin nonusers in other ways that could have protected from death from cancer, for which we could not correct. However, this finding is worthy of further investigation in observational studies,” he continued. “If replicated in further observational studies, this would provide evidence in favor of conducting a randomized, controlled trial of simvastatin in lung cancer patients. We hope to conduct a similar analysis in a large cohort of lung cancer patients from Northern Ireland.”
Dr. Cardwell is the corresponding author of for the Cancer Epidemiology, Biomarkers & Prevention article.
Funding for this study was provided by the Health and Social Care Research and Development Division of the Public Health Agency of Northern Ireland.
The study authors reported no conflicts of interest.
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®.
