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Statins and the risk of lung, breast, and colorectal cancer in the elderly.

Setoguchi S, Glynn RJ, Avorn J, Mogun H, Schneeweiss S

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Suite 3030, Boston, MA 02130, USA. ssetoguchi@partners.org

BACKGROUND: Although most randomized trials and meta-analyses suggest a slight or no increase in the risk of cancer in statin users, results from observational studies have been conflicting, and some have even suggested a large protective effect of statins on certain cancers. Long-term statin users tend to be healthier, less frail, and more adherent to therapy than nonusers, however. This could explain such apparent "protective" effects. METHODS AND RESULTS: We conducted the present cohort study by linking data from a large state drug benefit program with cancer registry data and Medicare healthcare utilization data. We identified all initiators of statins; initiators of glaucoma medications, another preventive drug, served as a comparison group. Outcomes included all registry-identified cases of colorectal, lung, and breast cancer. Multivariable Cox proportional models were used to adjust for confounding. Patient characteristics were similar in both groups, but statin initiators (n=24,439) were slightly younger and used some services more frequently than glaucoma drug initiators (n=7284). The mean follow-up was 2.9 years, with the longest follow-up being 8.4 years. Incidence rates of colorectal, lung, and breast cancers in both groups were very similar to rates in the general population. Adjusted hazard ratios were 0.96 (95% CI, 0.70 to 1.31) for colorectal cancer, 1.11 (95% CI, 0.77 to 1.60) for lung cancer, and 0.99 (95% CI, 0.74 to 1.33) for breast cancer. CONCLUSIONS: These data from a large population of typical older patients who began using statins indicate that it is unlikely that statins confer a clinically important decrease or increase in the risk of colorectal, lung, or breast cancer over the durations studied.

Published 3 January 2007 in Circulation, 115(1): 27-33.
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