Population-wide impacts of aspirin, statins, and metformin use on prostate cancer incidence and mortality

Abstract

We evaluated the association between aspirin, statins, and metformin use and prostate cancer (PC) incidence and mortality using a large population-based dataset. 388,760 men who participated in national health screening program in Korea during 2002–2003 were observed from 2004 to 2013. Hazard ratios of aspirin, statins, and metformin use for PC incidence and PC mortality were calculated with adjustment for simultaneous drug use. Cumulative use of each drug was inserted as time-dependent variable with 2-year time windows. Aspirin use ≥ 1.5 year (per 2-year) was associated with borderline decrease in PC mortality when compared to non-users (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.50–1.02). Statins use was not associated with either PC incidence or PC mortality. Metformin ever-use was associated with decreased PC incidence compared with non-diabetics (aHR 0.86, 95% CI 0.77–0.96). Diabetics who were not using metformin or using low cumulative doses had higher PC mortality than non-diabetics (aHR 2.01, 95% CI 1.44–2.81, and aHR 1.70, 95% CI 1.07–2.69, respectively). However, subjects with higher cumulative doses of metformin did not show increased PC mortality. In conclusion, metformin use was associated with lower PC incidence. Use of aspirin and that of metformin among diabetic patients were associated with lower PC mortality.

Chemopreventive Effects of Concomitant or Individual Use of Statins, Aspirin, Metformin, and Angiotensin Drugs: A Study Using Claims Data of 23 Million Individuals

“…Supported by a Korean study based on claims data of a large population [ 7 ], our study also found a significantly reduced risk of prostate cancer. A Swedish cohort study, nonetheless, suggested no preventive effect of metformin against prostate cancer [ 6 ].…”

“…Statins, as a class of lipid-lowering agents used for hypercholesterolemia treatment and cardiovascular disease (CVD) prophylaxis [ 2 ], are found to be associated with reduced risks of hepatic [ 3 ] and pancreatic [ 2 , 4 ] cancers. The prostate cancer risk among statin users, as opposed to non-users, remains inconclusive, suggested to be reduced [ 5 ], increased [ 6 ], or not significantly associated with use of statins [ 7 ]. Aspirin, a cyclooxygenase and thromboxane inhibitor indicated for pain, inflammation, and CVDs, has shown associations with lowered risks of gastrointestinal cancers, including esophageal [ 8 , 9 ], stomach [ 10 ], liver [ 11 ], and colorectal [ 12 ] cancers.…”

“…The chemopreventive effect of aspirin against pancreatic cancer could be nonsignificant [ 13 , 14 ] or marginal [ 15 ] in general, albeit significant in postmenopausal women [ 16 ]. Metformin is an anti-hyperglycemic agent prescribed for type 2 diabetes mellitus [ 2 ], known in recent years for its negative association with cancer risks of various sites, such as head and neck [ 17 ], lung [ 18 ], breast [ 19 ], liver [ 20 , 21 ], pancreas [ 2 ], colorectum [ 19 ], and debatably, prostate, with conflicting results published in previous studies [ 6 , 7 ]. ACEIs and ARBs (ACEIs/ARBs) exert an inhibitory effect on the renin-angiotensin-aldosterone system (RAAS), approved for CVDs or diabetic nephropathy.…”

A functionalized graphene oxide with improved cytocompatibility for stimuli-responsive co-delivery of curcumin and doxorubicin in cancer treatment

“…Cancer is one of the main causes of death in the world 1 – 3 . The most common strategies for the treatment of cancer are surgery, radiotherapy, and chemotherapy 4 – 6 .…”

Mutant p53, the Mevalonate Pathway and the Tumor Microenvironment Regulate Tumor Response to Statin Therapy

“…Statin users of at least 6 months had significantly lower risk of esophageal, stomach and colorectal cancer incidence as well as decreased cancer mortality [ 139 ]. Additionally, statin use has also been shown to be associated with decreased incidence in lung [ 140 ], breast [ 141 ], gynecologic [ 142 ], pancreatic [ 143 ] and prostate [ 144 ] cancers. Taken together, statins have a protective effect in preventing cancer incidence in individuals with or without comorbidity risk factors when taken for a prolonged period.…”