Statins Dose-Dependently Exert Significant Chemopreventive Effects Against Various Cancers in Chronic Obstructive Pulmonary Disease Patients: A Population-Based Cohort Study

Abstract

PURPOSE: Chronic obstructive pulmonary disease (COPD) is associated with an increased cancer risk. We evaluated the chemopreventive effect of statins against all cancers in COPD patients and identified the statin with the strongest chemopreventive effect.PATIENTS AND METHODS: All patients diagnosed with COPD at health care facilities in Taiwan (n = 116,017) from January 1, 2001, to December 31, 2012, were recruited. Each patient was followed to assess the following protective and risk factors for all cancers: age; sex; comorbidities (diabetes, hypertension, dyslipidemia) and the Charlson comorbidity index [CCI]); urbanization level; monthly income; and nonstatin drug use. The index date of statins use was the date of COPD confirmation. Propensity scores (PSs) were derived using a logistic regression model to estimate the effect of statins by considering the covariates predicting intervention (statins) receipt. To examine the dose-response relationship, we categorized statin use into four groups in each cohort (<28 [statin nonusers], 28-90, 91-365, and >365 cumulative defined daily dose).RESULTS: After PS adjustment for age, sex, CCI, diabetes, hypertension, dyslipidemia, urbanization level, and monthly income, we analyzed the all-cancer risk. The adjusted hazard ratios (aHRs) for the all-cancer risk were lower among statin users than among statin nonusers (aHR = 0.46, 95% confidence interval: 0.43 to 0.50). The aHRs for the all-cancer risk were lower among patients using rosuvastatin, simvastatin, atorvastatin, pravastatin, and fluvastatin than among statin nonusers (aHRs = 0.42, 0.55, 0.59, 0.66, and 0.78, respectively). Sensitivity analysis indicated that statins dose-dependently reduced the all-cancer risk.CONCLUSION: Statins dose-dependently exert a significant chemopreventive effect against various cancers in COPD patients. In particular, rosuvastatin has the strongest chemopreventive effect.

Rosuvastatin and Its Evolving Role as a Vascular Remodeling and Antiproliferative Agent in Different Systemic Malignancies

“…Not surprisingly, Chen et al (2015) reported an odds ratio of 0.22 when analyzing the association between RST administration and the decreased risk of hepatocellular carcinoma in individuals with diabetes. The authors reported an odds ratio of 0.24 when RST was coadministered with metformin.The above data were recently confirmed by Chen et al (2016) in a recent study, in which they reported that RST especially has a marked chemopreventive effect against various cancers in patients with chronic obstructive pulmonary disease. The above examples further confirm the antineoplastic activity of RST in different systemic malignancies.…”

“…The above data were recently confirmed by Chen et al (2016) in a recent study, in which they reported that RST especially has a marked chemopreventive effect against various cancers in patients with chronic obstructive pulmonary disease. The above examples further confirm the antineoplastic activity of RST in different systemic malignancies.…”

Association between chronic obstructive pulmonary disease and ventricular arrhythmia: a nationwide population-based cohort study

“…The National Health Insurance (NHI) program, established in 1995, provides health insurance coverage to >98% of the population of Taiwan (which approximately 23 million). The NHI Research Database (NHIRD) has been extensively analyzed and validated previously 38 , 39 . The NHIRD research committee and the Joint Institutional Review Board of Taipei Medical University approved our study protocol (TMU-JIRB No.…”

Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case‐control frequency‐matched study

“…The NHIRD is maintained by the NHI program, which is a compulsory program established in 1995 that insures 99% of all residents of Taiwan (approximately 23 million). Hundreds of articles based on NHIRD data have been published in peer‐reviewed international journals14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26 and the detailed data provided in these articles have supported the work of physicians and policymakers 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26. Individual information was anonymized before the NHIRD was released for research purposes.…”