Statin use and all-cause and cancer mortality: BioBank Japan cohort

Yokomichi, Hiroshi; Nagai, Akiko; Hirata, Makoto; Tamakoshi, Akiko; Kiyohara, Yutaka; Kamatani, Yoichiro; Muto, Kaori; Ninomiya, Toshiharu; Matsuda, Koichi; Kubo, Michiaki; Nakamura, Yusuke; Yamagata, Zentaro

doi:10.1016/j.je.2016.12.011

Cited by 30 publications

(25 citation statements)

References 40 publications

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“…Kaplan-Meier survival curves also revealed no difference. This is in accordance with a recently published cohort study including 41,900 patients [ 46 ]. Since statins are immune-modulating [ 47 ], it is possible that symptoms are delayed and that patients using statins receive their diagnosis at a later stage and therefore have a lower survival rate.…”

Section: Discussionsupporting

confidence: 93%

Statin consumption as a risk factor for developing colorectal cancer: a retrospective case study

et al. 2017

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BackgroundStatins are the backbone of lipid-lowering therapy and are among the most commonly prescribed drugs in the elderly population in Sweden today. Colorectal cancer is the second most common cancer in men and women, after prostate and breast cancer, respectively, with a median age of 72 years at diagnosis. Statins induce mitochondrial damage leading to accumulation of reactive oxygen species in the cell. Reactive oxygen species can cause mutations in mitochondrial as well as nuclear DNA leading to the development of cancer. Our hypothesis was that statins increase the risk for colorectal cancer.MethodsA case study was performed on consecutive cases of colorectal cancer diagnosed at Norrlands University Hospital (NUS) in Umeå between 2012 and 2015 (n = 325). Patients diagnosed with diabetes mellitus type II (DM II n = 65) were excluded in the primary endpoint analysis (occurrence of colorectal cancer). As control, three databases were used to create an age-matched population in order to calculate the proportion of inhabitants using statins in the county of Västerbotten, Sweden. A secondary endpoint was cancer-specific survival among our study group of colorectal cancer patients, including those with DM II, investigating whether there was a difference if the patient was a ‘recent’ statin user or not at the time of diagnosis.ResultsStatin use at the time of colorectal cancer diagnosis in the study group was 23.8%. The corresponding figure in an age-matched population in Västerbotten was 24.6%. Using a one-proportional one-sided z test, there was no significant difference between these (23.8%, 95% CI 18.6–29.0%, p = 0.601). When comparing groups 20–64 years of age, the difference was greater with recent statin use in 17.8% in the study population and 11.9% in Västerbotten (17.8%, 95% CI 9.0–26.6%, p = 0.059). When considering cancer-specific survival, no significant difference in survival was seen when comparing ‘former/never’ statin users as reference category with ‘recent’ users diagnosed with colorectal cancer (HR 1.39, 95% CI 0.89–2.16).ConclusionsNo significant increase in risk for developing colorectal cancer among patients (type II diabetics excluded) medicated with statins was found. We found no correlation between ‘recent’ statin use at the time of diagnosis and cancer-specific survival.

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Section: Discussionsupporting

confidence: 93%

Statin consumption as a risk factor for developing colorectal cancer: a retrospective case study

et al. 2017

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“…This finding implies that an elevated FFA level may be a potential biomarker for cancers. Some studies (Nayan et al 2017;Yokomichi et al 2017;Li et al 2019a, b) have found that statin use in cancer improves survival outcomes and increases overall survival. Our results can also explain why lipid-lowering therapy can improve clinical outcomes since cancer patients have elevated FFA levels even when serum TGs are normal.…”

Section: Discussionmentioning

confidence: 99%

A high serum-free fatty acid level is associated with cancer

Zhang

Han

et al. 2019

J Cancer Res Clin Oncol

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Purpose The objectives of this work were to investigate whether the serum-free fatty acid (FFA) level is meaningful in cancer patients and its role in cancer diagnosis. Methods A total of 2206 patients were divided into a cancer group (n = 1019) and a noncancer group (n = 1187). Age, sex, body mass index (BMI), and serum FFA and serum albumin levels were collected. Cancer patients were divided into subgroups according to the location of the cancer. We then compared serum FFA levels among the tumor subgroups. A receiver operating characteristic (ROC) curve analysis was performed to further evaluate the diagnostic ability of the FFA level. SPSS 22.0 software was used to analyze the results. Results The FFA level was higher in the cancer group than in the noncancer group. According to the multivariate analysis, there was also an increased risk of cancer associated with a high FFA level after adjusting for old age, female sex, and a low BMI. In the subgroup analysis, the FFA level in patients with lung cancer, gastric cancer, thyroid cancer, rectal cancer, colon cancer, and ovarian cancer was significantly higher than that in noncancer patients. The area under the effect-time curve (AUC) of FFAs in the whole cancer group was 0.58, while the thyroid cancer, rectal cancer, and ovarian cancer subgroups had AUCs > 0.6. Conclusion Our study provides clinical evidence to support that fatty acid metabolism is associated with cancers and demonstrates that a high FFA level in the serum may be an indicator of cancer.

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“…Recently, there have been many epidemiologic studies and meta-analyses on the beneficial effect of statin on cancer incidence and mortality or survival. However, the results were conflicting on these associations [10][11][12]. In addition, some of these reported associations could be caused by biases.…”

Section: Introductionmentioning

confidence: 99%

Statin and Cancer Mortality and Survival: An Umbrella Systematic Review and Meta-Analysis

Jeong

Lee

Kim

et al. 2020

JCM

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The aim of this study is to provide an overview and understand the strength of evidence and the extent of potential biases and the validity of claimed associations between the use of statins and cancer mortality or survival. We performed a comprehensive umbrella review of meta-analyses and systematically appraised the relevant meta-analyses of observational studies on the associations between statin use and cancer mortality or survival in various kinds of cancer. We searched the PubMed database and screened the reference list of relevant articles. We obtained the summary effect, 95% confidence interval, heterogeneity, and also examined small study effects and 95% prediction intervals for effect sizes, and the level of evidence was determined from the criteria. Regarding cancer mortality, statin use showed convincing evidence for an association with a reduced cancer-specific mortality rate for colorectal cancer. Four associations with reduced all-cause mortality (for breast cancer, colorectal cancer, endocrine-related gynecological cancer, and ovarian cancer) had a suggestive evidence. Moreover, analyses in nine cancers showed a weak level of evidence, while the remaining 15 did not indicate significant changes in either direction. Although there was a preventive effect of statin on cancer mortality in some cancer types, the evidence supporting the use of statins to reduce cancer mortality or survival was low.

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Statin use and all-cause and cancer mortality: BioBank Japan cohort

Cited by 30 publications

References 40 publications

Statin consumption as a risk factor for developing colorectal cancer: a retrospective case study

Statin consumption as a risk factor for developing colorectal cancer: a retrospective case study

A high serum-free fatty acid level is associated with cancer

Statin and Cancer Mortality and Survival: An Umbrella Systematic Review and Meta-Analysis

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