Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study

Abstract

Statins are widely used to lower blood cholesterol and reduce risk for cardiovascular diseases, but attention has recently focused on a role in cancer prevention or therapy. Here we present data from a large case-control study addressing whether statin use can lower the risk for epithelial ovarian cancer (EOC). Between 1992 and 2008, data including medications used for at least 6 months were collected from 2,040 cases with EOC and 2,100 frequency-matched controls without the disease who participated in the New England Case Control study. We used unconditional logistic regression controlling for matching factors and potential confounders to examine the association between statin use and the risk for EOC. Overall, women who used statins had 32% lower risk of ovarian cancer compared to non-users (Odds ratio (OR) 0.68, 95% Confidence Interval (CI): 0.54-0.85), adjusting for the matching factors and other covariates. The reduced risk was most apparent in women taking a lipophilic statin who began use after age 49, and who had used them 2-4.9 years. Statin use was associated with lower risks for both serous and non-serous histologic subtypes with the strongest effect seen for mucinous and mixed epithelial subtypes. The association became apparent about a decade after the introduction of statins and did not appear to be confounded by indications for use of statins or medications used concomitantly. In this case-control study, statins were found to lower the risk for both serous and non-serous EOC and especially mucinous EOC.

Do statins play role in reducing the incidence and mortality of ovarian cancer? A systematic review and meta-analysis

“…After the study of the finally enrolled 24 articles, two other studies were excluded because the effect size of statin on the incidence or mortality of OC had not been calculated or not been reported in the study and four studies were found as being irrelevant to my research according to the information of the full texts of the articles. Eighteen articles were selected for final analysis, of which ten articles were included for the assessment of the relationship between statin use and the risk of developing OC [ 11 , 12 , 16-18 , 22 , 23 , 32-34 ], and nine articles for the relationship between post-diagnosis statin consumption and OC mortality [ 11 , 13-15 , 19-21 , 35 , 36 ]. It should be noted that Lavie et al study [ 11 ], addressed both the risk of incidence and mortality of from OC ( Fig.…”

“…There were 7,943 cases of OC incidence reported in the included studies. Among the studies included [ 11 , 12 , 16-18 , 22 , 23 , 32-34 ], four studies were cohort studies with total sample size of 428,613 individuals [ 17 , 22 , 33 , 34 ], five studies were case-control with total sample size equal to 82,4891 individuals [ 11 , 12 , 16 , 18 , 32 ] and one was a clinical trial with total sample size equal to 997 individuals [ 23 ].…”

“…The reviewed articles had been published between 2001-2018 Six of the included studies were conducted in USA [ 12 , 17 , 22 , 23 , 33 , 34 ], three in Europe [ 16 , 18 , 32 ] and one in Asia [ 11 ]. The sample size was 682-748, 282 participants and the mean follow-up of the participants period was 59-130 months ( Tab.…”

“…This meta-analysis included ten studies investigating the association between statin consumption and the risk of developing OC [ 11 , 12 , 16-18 , 22 , 23 , 32-34 ]. Adjusted variables in the assessment of the relationship between statin use and risk of OC incidence are shown in Table II .…”

“…Recent studies have reported that statin could reduce the risk of OC incidence [ 11 , 12 ] and also its post-diagnosis use can improve the survival of OC patients [ 11 , 13-15 ]. In contrast, some studies have not reported any strong evidence on the protective effect of statins in reducing the risk of incidence [ 16-18 ] and mortality from OC [ 19-21 ].…”