Statin use and mortality among endometrial cancer patients: a Danish nationwide cohort study

Abstract

Statin use has been linked to improved prognosis of some cancer types, however, for endometrial cancer, the results are equivocal. We therefore examined the effect of statin use on endometrial cancer mortality. From the Danish Cancer Registry, we identified all women in Denmark aged 30-84 years with primary endometrial cancer during 2000-2012. Data on drug use, mortality outcomes and potential confounders were retrieved from nationwide registries. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for endometrial cancer-specific and other-cause mortality associated with statin use. Among 6,694 endometrial cancer patients, 753 died from endometrial cancer and 765 from other causes during a median follow-up of 4.5 year (interquartile range: 1.9-8.1). We observed an inverse association between time-varying postdiagnosis statin use (≥2 prescriptions) and endometrial cancer mortality (HR: 0.61, 95% CI: 0.48-0.77) compared to non-use (<2 prescriptions). The associations did not differ substantially by intensity or cumulative amount of statin use. In secondary analyses including prediagnosis statin use, we observed reduced mortality among both continuing (pre- and postdiagnosis) users (HR 0.70, 95% CI 0.53-0.92) and new (postdiagnosis only) users (HR 0.43, 95% CI 0.29-0.65) compared to "never users." In sensitivity analyses with fixed exposure periods after the endometrial cancer diagnosis, the inverse association was more pronounced more than 5 years after the diagnosis. Our findings suggest that statin use may be associated with improved survival in endometrial cancer patients.

An Israeli Gynecologic Oncology Group study of statin use and endometrial cancer prognosis

“…This cohort suggested an inverse association between statin use after diagnosis (≥2 prescriptions) and endometrial cancer mortality (HR 0.61; 95% CI, 0.48–0.77) compared with nonusers (<2 prescriptions). In this study, although with a larger cohort, the associations did not differ substantially by intensity or cumulative amount of statin use …”

“…In this study, although with a larger cohort, the associations did not differ substantially by intensity or cumulative amount of statin use. 26 Three smaller studies have reported statistically significant reductions in overall mortality of 37%-65% associated with statin use among endometrial cancer patients. [21][22][23] A retrospective cohort study of 985 endometrial cancer cases by Nevadunsky et al 24 reported improved disease-free survival among statin users compared with nonusers (HR 0.63; 95% CI, 0.40-0.99).…”

Serum calcium is a novel parameter to assess metabolic syndrome in endometrial carcinoma

“…We previously found that metformin improved the outcome of grade I endometrial cancer in fertility-sparing treatment with increasing HbA1C [16]. And long-term use of statins lowered the risk [17] and improved the survival of endometrial cancer [18]. Basic research found that antitumor effect of these drugs may performed by Ca 2+ .…”

The association between statin use and endometrial cancer survival outcome

“…Eight studies were cohort studies, [16,32–35,37–39] and 1 study was a case–control study. [36] Five articles studied the relationship between the use of statins and the disease-specific survival of endometrial cancer, [16,32,33,38,39] 3 articles discussed the overall survival, [34,36,37] and 1 article considered the overall survival and progression-free survival. [35] One of these studies was published in the form of an abstract.…”