Statins Reduce the Risk of Lung Cancer in Humans

Khurana, Vikas; Bejjanki, Hanmanth R.; Caldito, Gloria; Owens, Michael W.

doi:10.1378/chest.06-0931

Cited by 189 publications

(55 citation statements)

References 40 publications

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“…Therefore, time-independent exposure definitions will introduce a bias when the duration of follow-up varies with the outcome. The persistence of this type of time-related bias in peer-reviewed publications [16][17][18] confirms the need for increased awareness of this methodological pitfall. 19 Contributors MDM contributed to the concept and design of the study, the analysis of data, the interpretation of results and the writing of the article.…”

Section: Resultsmentioning

confidence: 84%

The impact of time-window bias on the assessment of the long-term effect of medication adherence: the case of secondary prevention after myocardial infarction

Martino¹,

Kirchmayer²,

Agabiti³

et al. 2015

BMJ Open

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ObjectivesTime-window bias was described in case–control studies and led to a biased estimate of drug effect. No studies have measured the impact of this bias on the assessment of the effect of medication adherence on health outcomes. Our goals were to estimate the association between adherence to drug therapies after myocardial infarction (MI) and the incidence of a new MI, and to quantify the error that would have been produced by a time-window bias.SettingThis is a population-based study. Data were obtained from the Regional Health Information Systems of the Lazio Region in Central Italy (around 5 million inhabitants).ParticipantsPatients discharged after MI in 2006–2007 were enrolled in the cohort and followed through 2009.Outcome measureThe study outcome was reinfarction: either mortality, or hospital admission for MI, whichever occurred first.DesignA nested case–control study was performed. Controls were selected using both time-dependent and time-independent sampling. Adherence to antiplatelets, β-blockers, ACE inhibitors/angiotensin receptor blockers (ACEI/ARBs) and statins was calculated using the proportion of days covered (PDC).ResultsA total of 6880 patients were enrolled in the cohort. Using time-dependent sampling, a protective effect was detected for all study drugs. Conversely, using time-independent sampling, the beneficial effect was attenuated, as in the case of antiplatelet agents and statins, or completely masked, as in the case of ACEI/ARBs and β-blockers. For ACEI/ARBs, the time-dependent approach produced ORs of 0.83 (95% CI 0.57 to 1.21) and 0.72 (0.55 to 0.95), respectively, for ‘0.50.75’ versus ‘0≤PDC≤0.5’. Using the time-independent approach, the ORs were 0.96 (0.65 to 1.43) and 1.00 (0.76 to 1.33), respectively.ConclusionsA time-independent definition of a time-dependent exposure introduces a bias when the length of follow-up varies with the outcome. The persistence of time-related biases in peer-reviewed papers strongly suggests the need for increased awareness of this methodological pitfall.

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Section: Resultsmentioning

confidence: 84%

The impact of time-window bias on the assessment of the long-term effect of medication adherence: the case of secondary prevention after myocardial infarction

Martino¹,

Kirchmayer²,

Agabiti³

et al. 2015

BMJ Open

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“…Studies on the effect of statins in improving mortality and morbidity of hospitalized patients are divided into studies evaluating either direct lipid lowering and cardio- or cerebrovascular protection effects or minimizing other inflammatory complications, including renal failure, bacteremia, infective events, etc (5-7). In a multicenter, randomized, double- blind, and prospective trial, atorvastatin had no statistically significant effect on the composite primary end point of cardiovascular death, nonfatal myocardial infarction, and stroke in patients with diabetes receiving hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

“…Decreasing the risk of dementia, protecting against the development of lung cancer (5), preserving renal function (6), and having protective effects against infection and sepsis (7) are known as pleiotropic effects of statins (8, 9). As such, there is a potential confounding and bias that patients receiving better medical care, and those more adherent to medical therapy, may be more likely to be taking statins and are also at lower risk for certain noncardiovascular diseases (9).…”

Section: Introductionmentioning

confidence: 99%

Statins and Postoperative Infections: A Randomized Clinical Trial

Shokouhi

Darazam

Sharifi

et al. 2014

Jundishapur J Microbiol

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Background:Observational studies, rather than randomized trials, revealed that statins might be associated with other benefits.Objectives:The present study aimed at evaluating the preventive effects of lovastatin when used as a prophylactic agent for early and late infective complications after surgery.Patients and Methods:A total of 149 patients undergoing elective intracranial and spinal surgeries, were enrolled in a double- blind randomized clinical trial in the department of neurosurgery of a teaching hospital. An amount of 20 mg lovastatin and the same dose of placebo, one day before the operation and three days after the surgery, were used for cases and controls, respectively. The patients were evaluated for local and systemic infections during hospitalization and 10, 30, 60 and 90 days after discharge.Results:A total of 149 patients, 78 men and 71 women with a mean age of 40.3 ± 16.5, were assigned to prophylactic protocols. 46 and 103 patients were in the case and control groups, respectively. Eight episodes of infection were detected, including six bacterial meningitis and two episodes of hospital- acquired pneumonia. All of the patients with documented postoperative infections were part of the placebo group, however, there were no significant statistical differences between the groups (P = 0.059).Conclusions:In spite of the differences between the two groups, the results did not significantly support the preventive effect of statins in postoperative infections.

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“…Earlier studies evaluating the association between statins and cancer in patients with diabetes included a Chinese population-based cohort study that reported that patients with type 2 diabetes, who were statin users, were less likely to develop all-site cancer during a median follow-up of 4.9 years (5.5 vs. 2.6 %; P < 0.001) (25). Other studies reported a possible protective effect of statins in patients with diabetes on lung (adjusted OR: 0.43; 95 % CI: 0.38 –0.49) (31) and pancreatic cancer (adjusted OR: 3.03; 95 % CI: 2.46 –3.71) (32). However, no earlier studies have specifically evaluated the effect of statins on CRC in a diabetic population.…”

Section: Discussionmentioning

confidence: 99%

Statins and the Risk of Colorectal Carcinoma: A Nested Case–Control Study in Veterans With Diabetes

et al. 2009

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OBJECTIVES Experimental data indicate a possible preventive effect for statins in colorectal cancer (CRC). However, the available epidemiological data are conflicting. METHODS We conducted a nested case –control study of veterans with diabetes in national databases of the Department of Veterans Affairs (VA) and Medicare-linked files. Cases were defined as incident CRC during January 2001 –December 2002, sampled on incidence density. VA pharmacy benefits management (PBM) files were used to identify filled prescriptions for statins. Multivariable conditional logistic regression models were used to estimate odds ratios (ORs) after adjusting for potential confounding variables. Stratified analyses were conducted for potential effect modifiers. RESULTS A total of 6,080 cases and 24,320 controls were examined. The mean age was 74 years, and the majority of patients were Caucasian (88 %) and male (99 %). Filled prescriptions of statins were recorded less frequently in cases (49 %) than in controls (52 %; OR: 0.88; 95 % confidence interval (95 % CI): 0.83 –0.93). This inverse association remained significant after adjusting for inflammatory bowel disease, diabetes severity, cholecystectomy, liver disease, filled prescriptions for sulfonylurea, aspirin or NSAID use, or colorectal evaluation. Simvastatin comprised the majority (87 %) of statin-filled prescriptions, and the association with risk of CRC with simvastatin was very similar to that of any statin. No significant associations were observed between the risk of CRC and nonstatin cholesterol (OR: 1.02; 95 % CI 0.88 –1.18) or triglyceride-lowering medications (OR: 0.96; 95 % CI: 0.87 –1.05). The significant inverse association was limited to Caucasians, patients without history of polyps, patients aged 65 years and older, and patients with colon cancer (excluding rectum). CONCLUSIONS The use of statins was associated with a small reduction in the risk of colon cancer in patients with diabetes. However, the causal link is not clear.

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Statins Reduce the Risk of Lung Cancer in Humans

Cited by 189 publications

References 40 publications

The impact of time-window bias on the assessment of the long-term effect of medication adherence: the case of secondary prevention after myocardial infarction

The impact of time-window bias on the assessment of the long-term effect of medication adherence: the case of secondary prevention after myocardial infarction

Statins and Postoperative Infections: A Randomized Clinical Trial

Statins and the Risk of Colorectal Carcinoma: A Nested Case–Control Study in Veterans With Diabetes

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