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Volume 184, Issue 2, Pages 494-500 (August 2010)


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The Association Between Statin Use and the Diagnosis of Prostate Cancer in a Population Based Cohort

Rodney H. Breaua, R. Jeffrey Karnesa, Debra J. Jacobsonb, Michaela E. McGreeb, Steven J. Jacobsenc, Ajay Nehraa, Michael M. Liebera, Jennifer L. St. SauverbCorresponding Author Informationemail address

Received 11 December 2009 published online 17 June 2010.

Purpose

The effect of statin medication use on the risk of prostate cancer is unknown.

Materials and Methods

We examined data from a longitudinal, population based cohort of 2,447 men between 40 and 79 years old who were followed from 1990 to 2007. Information on statin use was self-reported and obtained by biennial questionnaires. A randomly selected subset of men (634, 26%) completed biennial urological examinations that included serum prostate specific antigen measurements. Information on prostate biopsy and prostate cancer was obtained through review of community medical records.

Results

Of 634 statin users 38 (6%) were diagnosed with prostate cancer vs 186 (10%) of 1,813 nonstatin users. Statin use was associated with a decreased risk of undergoing prostate biopsy (HR 0.31; 95% CI 0.24, 0.40), receiving a prostate cancer diagnosis (HR 0.36; 95% CI 0.25, 0.53) and receiving a high grade (Gleason 7 or greater) prostate cancer diagnosis (HR 0.25; 95% CI 0.11, 0.58). Statin use was also associated with a nonsignificantly decreased risk of exceeding a prostate specific antigen threshold of 4.0 ng/ml (HR 0.63; 95% CI 0.35, 1.13). In addition, a longer duration of statin use was associated with a lower risk of these outcomes (all tests for trend p <0.05).

Conclusions

Statin use is associated with a decreased risk of prostate cancer diagnosis. This association may be explained by decreased detection or cancer prevention.

a Department of Urology, Mayo Clinic College of Medicine, Rochester, Minnesota

b Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota

c Southern California Permanente Medical Group, Pasadena, California

Corresponding Author InformationCorrespondence and requests for reprints: Department of Health Sciences Research, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55901 (telephone: 507-538-1460; FAX: 507-284-1516)

 Supported by the U.S. Public Health Service, National Institutes of Health (Grants DK58859, AR30582 and 1 UL1 RR024150-01) and Merck Research Laboratory.

 See Editorial on page 415.

 Financial interest and/or other relationship with Kaiser Permanente and Merck.

 Financial interest and/or other relationship with GlaxoSmithKline, Pfizer and Sanofi-Aventis Medical.

PII: S0022-5347(10)03277-5

doi:10.1016/j.juro.2010.03.149


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