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American Journal of Epidemiology Advance Access originally published online on June 12, 2008
American Journal of Epidemiology 2008 168(3):250-260; doi:10.1093/aje/kwn141
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Statin Use and Risk of Prostate Cancer: Results from a Population-based Epidemiologic Study

Ilir Agalliu1,2, Claudia A. Salinas1,3, Philip D. Hansten4, Elaine A. Ostrander5 and Janet L. Stanford1,3

1 Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
2 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
3 Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA
4 Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA
5 National Human Genome Research Institute, National Institutes of Health, Bethesda, MD

Correspondence to Dr. Janet L. Stanford, Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, 1100 Fairview Avenue N, M4-B874, Seattle, WA 98109-1024 (e-mail: jstanfor{at}fhcrc.org).

Received for publication February 23, 2008. Accepted for publication May 1, 2008.

Epidemiologic studies of statin use in relation to prostate cancer risk have been inconclusive. Recent evidence, however, suggests that longer-term use may reduce risk of more advanced disease. The authors conducted a population-based study of 1,001 incident prostate cancer cases diagnosed in 2002–2005 and 942 age-matched controls from King County, Washington, to evaluate risk associated with statin use. Logistic regression was used to generate odds ratios for ever use, current use, and duration of use. No overall association was found between statin use and prostate cancer risk (odds ratio (OR) = 1.0, 95% confidence interval (CI): 0.8, 1.2 for current use; OR = 1.1, 95% CI: 0.7, 1.8 for >10 years' use), even for cases with more advanced disease. Risk related to statin use, however, was modified by body mass index (interaction p = 0.04). Obese men (BMI ≥30 kg/m2) who used statins had an increased risk (OR = 1.5, 95% CI: 1.0, 2.2) relative to obese nonusers, with a stronger association for longer-term use (OR = 1.8, 95% CI: 1.1, 3.0 for ≥5 years' use). Although statin use was not associated with overall prostate cancer risk, the finding of an increased risk associated with statin use among obese men, particularly use for extended durations, warrants further investigation.

case-control studies; hydroxymethylglutaryl-CoA reductase inhibitors; obesity; odds ratio; prostatic neoplasms

Abbreviations: BMI, body mass index; CI, confidence interval; OR, odds ratio; PSA, prostate-specific antigen


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