Anton Pottegård1, Peter Clark2, Søren Friis3, Jesper Hallas4, Lars Lund5. 1. Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense C, Denmark. Electronic address: apottegaard@health.sdu.dk. 2. Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Clinical Institute, University of Southern Denmark, Odense C, Denmark. 3. Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen Ø, Denmark. 4. Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense C, Denmark. 5. Clinical Institute, University of Southern Denmark, Odense C, Denmark; Department of Urology, Odense University Hospital, Odense C, Denmark.
Abstract
BACKGROUND: Use of statins has been suggested to protect against renal cell carcinoma (RCC); however, studies have typically been underpowered, and the results are conflicting. OBJECTIVE: To determine whether the use of statins is associated with a reduced risk of RCC using high-quality registry data. DESIGN, SETTING, AND PARTICIPANTS: We conducted a nationwide case-control study based on all histologically verified cases of RCC in Denmark between 2002 and 2012 (n=4606) matched 1:10 to cancer-free controls. Data on drug use, comorbidity, and educational level were obtained from Danish nationwide prescription, patient, and demographic registries. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Odds ratios (ORs) and 95% confidence intervals (CIs) for RCC associated with long-term use (≥5 yr) of statins were estimated using conditional logistic regression, adjusting for potential confounders. RESULTS AND LIMITATIONS: The adjusted OR for RCC associated with long-term use of statins was 1.06 (95% CI, 0.91-1.23). Analyses stratified by duration of statin use, type of statin, and patient characteristics all yielded ORs close to unity, except for a slightly increased OR for RCC associated with long-term statin use among women (OR: 1.25; 95% CI, 0.96-1.62). The main limitation of our study was lack of information on lifestyle factors, notably obesity, which may have biased the risk estimates upward. CONCLUSIONS: Our study does not support an important chemopreventive effect of long-term statin use against RCC. The marginally increased and statistically insignificant risk estimates can readily be interpreted as a null finding, considering the lack of control for obesity and other lifestyle risk factors. PATIENT SUMMARY: Previous studies have shown that the use of cholesterol-lowering drugs (statins) may protect against renal cancer. In a large study including all Danish renal cancers during an 11-yr period, we found no evidence of such an effect.
BACKGROUND: Use of statins has been suggested to protect against renal cell carcinoma (RCC); however, studies have typically been underpowered, and the results are conflicting. OBJECTIVE: To determine whether the use of statins is associated with a reduced risk of RCC using high-quality registry data. DESIGN, SETTING, AND PARTICIPANTS: We conducted a nationwide case-control study based on all histologically verified cases of RCC in Denmark between 2002 and 2012 (n=4606) matched 1:10 to cancer-free controls. Data on drug use, comorbidity, and educational level were obtained from Danish nationwide prescription, patient, and demographic registries. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Odds ratios (ORs) and 95% confidence intervals (CIs) for RCC associated with long-term use (≥5 yr) of statins were estimated using conditional logistic regression, adjusting for potential confounders. RESULTS AND LIMITATIONS: The adjusted OR for RCC associated with long-term use of statins was 1.06 (95% CI, 0.91-1.23). Analyses stratified by duration of statin use, type of statin, and patient characteristics all yielded ORs close to unity, except for a slightly increased OR for RCC associated with long-term statin use among women (OR: 1.25; 95% CI, 0.96-1.62). The main limitation of our study was lack of information on lifestyle factors, notably obesity, which may have biased the risk estimates upward. CONCLUSIONS: Our study does not support an important chemopreventive effect of long-term statin use against RCC. The marginally increased and statistically insignificant risk estimates can readily be interpreted as a null finding, considering the lack of control for obesity and other lifestyle risk factors. PATIENT SUMMARY: Previous studies have shown that the use of cholesterol-lowering drugs (statins) may protect against renal cancer. In a large study including all Danish renal cancers during an 11-yr period, we found no evidence of such an effect.
Authors: Łukasz Zapała; Aleksander Ślusarczyk; Rafał Wolański; Paweł Kurzyna; Karolina Garbas; Piotr Zapała; Piotr Radziszewski Journal: Biomedicines Date: 2022-05-23