Statin use and risk of pancreatic cancer: Results from a large, clinic‐based case‐control study

Abstract

Background Statins are cholesterol-lowering medications with pleiotropic effects including alterations in growth signaling as well as immunomodulatory and anti-inflammatory effects that may alter cancer risk. Evidence from previous epidemiologic studies is inconsistent regarding whether statin use is associated with reduced risk of pancreatic cancer (PC). Methods Patients with confirmed diagnoses of PC (cases) were recruited from medical and surgical oncology clinics, with controls (frequency-matched by sex and age) recruited from general medicine clinics, at a high-volume academic medical center over a six-year period (2006–2011). Direct interviews were conducted using an epidemiological risk factor questionnaire covering topics such as medical history, lifestyle factors, and medication usage. Adjusted multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (95%CI) as estimates of the relative risk of PC. Results Data were obtained from 536 cases and 869 controls. Ever use of statins was associated with 34% reduced PC risk (OR=0.66, 95%CI 0.47–0.92). In sex-stratified analyses, risk was statistically significantly reduced in men only (men: OR=0.50, 95%CI 0.32–0.79; women: OR=0.86, 95%CI 0.52–1.43). Duration of use was inversely associated with PC risk (>10 year use: OR=0.51 overall; in men, OR=0.41, 95%CI 0.21–0.80; ptrend=0.006). Conclusions This is the largest case-control study to demonstrate an inverse association between statin use and PC risk. Risk reduction in statin users appears to be sex-specific and is more pronounced in long-term users. Further research is warranted to better characterize this association and clarify roles of underlying biologic mechanisms.

Statins and pancreatic cancer

“…Furthermore, in a matched case-control study, male smokers who were regular statin users had a significantly reduced OR for pancreatic cancer (42). In a large case-control study (1,405 participants), statin use in men (OR, 0.50; 95% CI, 0.32-0.79) and a duration of statin use of >10 years (OR, 0.51; 95% CI, 0.31-0.85) were significantly associated with a reduced risk of pancreatic cancer (43).…”

The role of statins as therapeutic agents in cancer

“…They found that the use of simvastatin and atorvastatin after cancer diagnosis is associated with longer survival in patients with non-metastatic pancreatic adenocarcinoma. Walker et al (2015) observed associations in men only, and PC risk was inversely related to the duration of statin use. Interestingly, results from meta-analyses of randomized controlled trial data show that statins may reduce the risk of acute pancreatitis and increase diabetes risk (Desai et al 2014), and these conditions are associated with increased PC risk (Walker et al 2015).…”

“…Walker et al (2015) observed associations in men only, and PC risk was inversely related to the duration of statin use. Interestingly, results from meta-analyses of randomized controlled trial data show that statins may reduce the risk of acute pancreatitis and increase diabetes risk (Desai et al 2014), and these conditions are associated with increased PC risk (Walker et al 2015). Simvastatin increased survival of pancreatic cancer patients more potently than the other statins .…”

“…Concerning the pancreatic cancer (PC), even though not all of the published data are convincing (Bonovas et al 2008;Bradley et al 2010;Chiu et al 2011;Cui et al 2012), in several studies statins have been proven to significantly decrease the PC risk (Khurana et al 2007;Nielsen et al 2012;Walker et al 2015;Chen et al 2016). Lee et al (2016) have shown that statin application was associated with a lower risk of cancer mortality, especially among simvastatin and atorvastatin users.…”

Statins and the risk of pancreatic cancer in Type 2 diabetic patients—A population‐based cohort study

“…12 One clinical-based casecontrol study in 2015 implied that risk reduction of pancreatic cancer in stain users may be apparent particularly in specific groups, such as in men and long-term users. 13 Diabetic patients have a greater likelihood of underlying hyperlipidemia 14 and a higher risk of cardiovascular disease, 15 which is leading to the stricter control of cholesterol levels. 16 Diabetic patients may use more statins compared to nondiabetic subjects and tend to have a higher risk of developing pancreatic cancer.…”