Statin use and risk of liver cancer: Evidence from two population‐based studies

Abstract

Epidemiological studies of statin use and liver cancer risk have produced conflicting results. We examined the association between statin use and risk of primary liver cancer in two large independent study populations taking account of important covariates and main indications of statins such as high cholesterol and chronic liver disease. We performed a nested case–control study within the Scottish Primary Care Clinical Informatics Unit (PCCIU) database. Five controls were matched to cases with primary liver cancer and we used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with statin use. We also conducted a prospective cohort study within the UK Biobank using self‐reported statin use and cancer‐registry recorded primary liver cancer outcomes. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs. In the PCCIU case–control analysis, 434 liver cancer cases were matched to 2,103 controls. In the UK Biobank cohort, 182 out of 475,768 participants developed incident liver cancer. Statin use was associated with 39% lower risk of liver cancer in the PCCIU (adjusted OR 0.61, 95% CI 0.43–0.87). When we examined specific subtypes of liver cancer in the UK Biobank, statin use was associated with lower risk of hepatocellular carcinoma (HCC; adjusted HR, 0.48; 95% CI, 0.24–0.94) but not intrahepatic bile duct carcinoma (IBDC; adjusted HR, 1.09; 95% CI, 0.45–2.64). In conclusion, we found a consistent inverse relationship between statin use and risk of primary liver cancer which was only seen for HCC but not IBDC.

Statin Use Decreases the Incidence of Hepatocellular Carcinoma: An Updated Meta-Analysis

“…Nine studies [8,10,[12][13][14]18,20,22] were retrospective case-control, twelve were cohort studies [9,11,[15][16][17]19,23,24,26,27,29,30], one study was a randomized controlled trial (RCT) [28], and two studies that were included as RCTs represented individual patient data analysis of patients enrolled in prospective controlled trials of cholesterol in heart disease [31,32]. The study by Tran et al [25] included two different stages, a nested case-control and a prospective cohort drawn from two different populations, hence they were analyzed separately.…”

Perceived dietary salt intake and the risk of primary liver cancer: a population‐based prospective study

“…Tran et al ( 27 ) found that taking lipid‐lowering agent was associated with the risk of liver cancer. Therefore, to further eliminate the interference of potential confounders on the results, sensitivity analysis and subgroup analysis were conducted, respectively.…”

Protocol for systematic review and meta-analysis: impact of statins as immune-modulatory agents on inflammatory markers in adults with chronic diseases

“…8 Statins may also lower the risk of liver cancer. 9 The anti-inflammatory effects vary among the different types of currently licensed statins with various meta-analyses reporting differential efficacy in reducing inflammation in chronic obstructive pulmonary disease (COPD). 10 Statins (table 1) are categorised into two main groups according to their solubility: (1) hydrophilic statins which include pravastatin and rosuvastatin and these display high hepato-selectivity with increased first-pass effect and (2) lipophilic statins which are characterised by passive diffusion into cells; these include atorvastatin, simvastatin, lovastatin, fluvastatin, pitavastatin and cerivastatin.…”