Statins and pancreatic cancer risk in patients with chronic pancreatitis: A Danish nationwide population‐based cohort study

Abstract

Statins (HMG‐CoA reductase inhibitors) have antiinflammatory and possibly anticancer properties. We hypothesized that statin use is associated with lower risk of pancreatic cancer in patients with chronic pancreatitis. This nationwide population‐based cohort study included all Danish patients diagnosed with incident chronic pancreatitis from 1 January 1996 to 31 December 2012. We used the Danish National Prescription Registry to ascertain information on statin prescriptions for members of the study population before and after their pancreatitis diagnosis. We computed crude incidence rates, incidence rate ratios (IRRs) and adjusted hazard ratios (HRs) with associated 95% confidence intervals (CIs) for pancreatic cancer, comparing statin users with nonusers. We computed HRs using Cox proportional hazards regression with statins treated as a time‐varying exposure lagged by 1 year, adjusting for age, sex, socioeconomic status and individual comorbidities. The study included 8,311 chronic pancreatitis patients with a median age of 54 years. We observed 153 pancreatic cancers during 60,365 person‐years of follow‐up. The unadjusted IRR comparing statin users with nonusers was 1.00 (95% CI: 0.60–1.60). Adjustment for potential confounders only had a small impact on the estimate (adjusted HR: 0.90; 95% CI: 0.56–1.44). Our findings suggest that statin use is not associated with pancreatic cancer risk in patients with chronic pancreatitis.

The association between use of statin or aspirin and pancreatic ductal adenocarcinoma: A nested case‐control study in a Korean nationwide cohort

“…Statin use significantly decreased the risk of pancreatic cancer in nearly 50% in patients with type 2 DM, 47 but that for patients with CP was not clear because two previous studies reported inconsistent conclusions. 48,49 Meanwhile, a nearly 30% lower risk for pancreatic cancer with regular aspirin use among participants with DM was observed in a large cohort study, 20 which was similar to result of this study, but it does not appear to be affected by the cumulative dose of aspirin use. Few studies have been conducted on the relationship between aspirin use and PDAC for patients with risk factors, and it is necessary to further evaluate in the future.…”

“…Recently, well‐designed studies with a large number of patients have reported the relationship between statin use and PDAC in high risk patients with DM or CP. Statin use significantly decreased the risk of pancreatic cancer in nearly 50% in patients with type 2 DM, but that for patients with CP was not clear because two previous studies reported inconsistent conclusions . Meanwhile, a nearly 30% lower risk for pancreatic cancer with regular aspirin use among participants with DM was observed in a large cohort study, which was similar to result of this study, but it does not appear to be affected by the cumulative dose of aspirin use.…”

“…In multivariate logistic regression analysis, the aspirin model was adjusted for aspirin ever user and the statin model was adjusted for statin ever user. Chronic pancreatitis (aOR in aspirin model, 48…”

Design flaws in statins and pancreatic cancer research

“…Dear Sir, We read with great interest the recently published study on the association between statins and pancreatic cancer risk in patients with chronic pancreatitis (CP). 1 Preventing the progression from CP to pancreatic cancer is of great significance. Statins are widely used as cholesterol-lowering drugs nowadays.…”

Author's Reply to: “Design flaws in statins and pancreatic cancer research” (IJC‐19‐0941)

“…Dear Sir, We thank Liu et al for their interest in our recent study in International Journal of Cancer on statins and pancreatic cancer risk in patients with chronic pancreatitis. 1 Liu et al raises concern about some potential flaws in our study design, to which we would like to reply.…”