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Post Diagnosis Statin Use and Mortality in Danish Patients with Prostate Cancer

Increasing evidence indicates that statin use may reduce mortality from prostate cancer. In this work, we examined whether post diagnosis statin use was associated with reduced cancer-specific mortality or all-cause mortality among patients with prostate cancer in Denmark.

From nationwide Danish registries, we identified all patients with incident prostate adenocarcinoma from 1998 to 2011 and retrieved data on tumor and patient characteristics, drug use, and primary treatment.

We defined post diagnosis use (two or more prescriptions) of statins as a time-varying covariate with 1-year lag. Cox proportional hazards regression models used to compute hazard ratios (HRs) for prostate cancer-specific mortality and all-cause mortality through 2013 associated with post diagnosis statin use. In secondary and sensitivity analyses, we assessed statin use within exposure periods of 1 year or 5 years after prostate cancer diagnosis and evaluated the influence of pre diagnosis statin use.

Results: Among 31,790 patients, 7,365 died of prostate cancer and 11,811 died from other causes during a median follow-up of 2.8 years (interquartile range, 1.3 to 5.1 years) from 1 year after diagnosis.

Post diagnosis statin use was associated with adjusted HRs of 0.83 (95% CI, 0.77 to 0.89) for prostate cancer mortality and 0.81 (95% CI, 0.76 to 0.85) for all-cause mortality. Similar results were observed in 1-year and 5-year sensitivity analyses. No substantial effect measure modification was found with estimated dose or type of statin, clinical stage, Gleason score, or with pre diagnosis statin use; however, patients who were diagnosed early in the study period or who underwent radical prostatectomy or endocrine therapy exhibited slightly lower HRs for prostate cancer mortality with post diagnosis statin use than did those in the overall analyses.

Conclusion: Post diagnosis statin use was associated with reduced mortality from prostate cancer; however, it remains to be established whether this association is causal.

Author information:

Signe Benzon Larsen1, Christian Dehlendorff1, Charlotte Skriver1, Susanne Oksbjerg Dalton1, Christina Gade Jespersen4,5, Michael Borre5, Klaus Brasso2, Mette Nørgaard5, Christoffer Johansen1,2, Henrik Toft Sørensen5, Jesper Hallas6, Søren Friis1,3,5.

1. Danish Cancer Society Research Center
2. Copenhagen University Hospital; 
3. University of Copenhagen, Copenhagen
4. Viborg Hospital, Viborg; 
5. Aarhus University Hospital, Aarhus
6. University of Southern Denmark, Odense, Denmark