Elizabeth A Platz1, Catherine M Tangen2, Phyllis J Goodman2, Cathee Till2, Howard L Parnes3, William D Figg4, Demetrius Albanes5, Marian L Neuhouser6, Eric A Klein7, M Scott Lucia8, Ian M Thompson9, Alan R Kristal6. 1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland. Electronic address: eplatz@jhu.edu. 2. SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington. 3. Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. 4. Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. 5. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. 6. Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. 7. Center for Clinical and Translational Research, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. 8. University of Colorado Denver School of Medicine, Aurora, Colorado. 9. Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio, Texas.
Abstract
PURPOSE: Prospective cohort studies support the hypothesis that statin drug users have a lower risk of aggressive prostate cancer. Whether statin drug use influences the risk of screen detected disease is less clear, possibly because of complex detection biases. Thus, we investigated this association in a setting in which men had low baseline serum prostate specific antigen concentration and were screened annually. MATERIALS AND METHODS: We performed a cohort study of 9,457 men 55 years old or older at randomization to the placebo arm ofPCPT (Prostate Cancer Prevention Trial). The men reported new use of medications quarterly. We estimated the multivariable adjusted HR of prostate cancer (574 cases in 62,192 person-years) for statin drug use and duration of use during the trial using Cox proportional hazards regression. RESULTS: During 7 years of followup statin drug use during the trial was not associated with the risk of total prostate cancer (HR 1.03, 95% CI 0.82-1.30), or lower grade (HR 0.96, 95% CI 0.71-1.29) or higher grade (HR 1.27, 95% CI 0.85-1.90) prostate cancer. Duration of use during followup was also not associated with the risk of total, or lower or higher grade disease (p trend=0.7, 0.5 and 0.2, respectively). CONCLUSIONS: These prospective results do not support the hypothesis that statin drugs protect against prostate cancer in the setting of regular prostate cancer screening.
RCT Entities:
PURPOSE: Prospective cohort studies support the hypothesis that statin drug users have a lower risk of aggressive prostate cancer. Whether statin drug use influences the risk of screen detected disease is less clear, possibly because of complex detection biases. Thus, we investigated this association in a setting in which men had low baseline serum prostate specific antigen concentration and were screened annually. MATERIALS AND METHODS: We performed a cohort study of 9,457 men 55 years old or older at randomization to the placebo arm of PCPT (Prostate Cancer Prevention Trial). The men reported new use of medications quarterly. We estimated the multivariable adjusted HR of prostate cancer (574 cases in 62,192 person-years) for statin drug use and duration of use during the trial using Cox proportional hazards regression. RESULTS: During 7 years of followup statin drug use during the trial was not associated with the risk of total prostate cancer (HR 1.03, 95% CI 0.82-1.30), or lower grade (HR 0.96, 95% CI 0.71-1.29) or higher grade (HR 1.27, 95% CI 0.85-1.90) prostate cancer. Duration of use during followup was also not associated with the risk of total, or lower or higher grade disease (p trend=0.7, 0.5 and 0.2, respectively). CONCLUSIONS: These prospective results do not support the hypothesis that statin drugs protect against prostate cancer in the setting of regular prostate cancer screening.
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