Prostate Cancer Development Is Not Affected by Statin Use in Patients with Elevated PSA Levels

Abstract

Background: The role of statins in prostate cancer (PCa) remains unclear. Conflicting evidence has been found concerning risk reduction with the use of statins on biochemical recurrence (BCR). In this study, we evaluated whether statin use decreases the incidence of advanced PCa in males with elevated prostate-specific antigen (PSA; ≥4.0 ng/mL) levels and determined whether statin use reduces the risk of BCR after radical prostatectomy (RP). Methods: Patients visiting the outpatient urology clinic of the VU Medical Center between 2006 and 2018 with elevated PSA were retrospectively analyzed. Biochemical recurrence after RP was defined as a PSA level of ≥0.2 ng/mL (measured twice). Results: A total of 1566 patients were included, of which 1122 (72%) were diagnosed with PCa. At the time of diagnosis, 252 patients (23%) used statins compared to 83 patients (19%) in the non-malignancy group (p = 0.10). No differences were found in the use of statins between the different risk groups. No correlation was found between the risk of BCR after RP and the use of statins in the total (p = 0.20), the intermediate-risk group (p = 0.63) or the high-risk group (p = 0.14). Conclusion: The use of statins does not affect PCa development/progression in patients with elevated PSA levels, nor the development of BCR after RP.

Attempts to use statins in cancer therapy: An update

“…In general, treatment with statins that preceded cancer diagnosis lowers the risk of cancer development and prolongs the overall survival in comparison with statin non-users or patients who started taking statins after a cancer diagnosis. For instance, studies have shown that the use of statins before a diagnosis is associated with a lower risk of pancreatic cancer, 2 non-Hodgkin lymphoma, 3 oesophageal adenocarcinoma 4 and brain cancer 5 but not breast cancer, 12 prostate cancer 6,7 or endometrial cancer. 8 Also, regular statin use before diagnosis modestly prolonged the survival of patients in comparison with non-users or non-regular users in pancreatic cancer, 9 gastric cancer, 10 head and neck squamous cell carcinoma, 11 breast cancers, 12 lung cancer, 13 uterine cervical cancer, 14 prostate cancer, 15 kidney cancer, 16 endometrial cancer 17 and multiple myeloma, 18 but not in colorectal cancer 19 or glioblastoma 20 (see Table 1).…”

Statin Use and the Risk of Prostate Cancer Biochemical Recurrence Following Definitive Therapy: A Systematic Review and Meta-Analysis of Cohort Studies

“…A total of 650 records were excluded after reading the title and abstract, and 50 records were excluded for not having full-text or original data. After reading the full text, 31 records were excluded due to lack of data about BCR and two records were excluded because they did not belong to cohort studies (one RCT ( 73 ) and one case–control ( 74 ) study). Finally, 33 studies met the inclusion criteria for the current review.…”

The association of statin use and biochemical recurrence after curative treatment for prostate cancer

“…We identified 27 studies for this meta-analysis, and the flow chart of the search and selection is shown in Figure 1 [10–36] . Specifically, 11484 patients with statin use and 25937 patients without such medication were included; 18 studies evaluated the impact of statin use in patients undergoing RP and 9 studies evaluated the impact of statin use in patients undergoing RT.…”