Long-term statin use protects against prostate cancer death

Originally Posted Here: https://www.health.harvard.edu/blog/long-term-statin-use-protects-against-prostate-cancer-death-2019010715760

Statins and other drugs that lessen cardiovascular disease risk by lowering blood lipids rank among the world’s most prescribed medications. And for the men who take them, accumulating evidence has for years pointed to another added benefit: a lower risk of developing prostate cancer.

Now researchers are reporting that long-term statin use (more than 10 years) can also reduce the odds of a prostate cancer death. The new findings come from a study led by Alison Mondul, a cancer epidemiologist at the University of Michigan School of Public Health.

Mondul says that most men develop slow-growing, indolent prostate cancers that will never become clinically relevant. Her goal with this new study, she says, was to look more specifically at whether statins protect against fatal prostate cancers.

Here’s what the researchers did

Since death from prostate cancer can take many years to occur, Mondul and her team needed a dataset with an adequate duration of follow-up. And the study they went to for data — the Atherosclerosis Risk in Communities Study (ARIC) — fit the bill with a launch date of 1985. The ARIC study enrolled nearly 16,000 men and women between the ages of 45 and 64, and monitored their heart disease outcomes until 2016. Mondul’s team zeroed in on 6,518 men from the ARIC cohort who had enrolled between 1990 and 1992 — the beginning of the statin era. Approximately 25% of those men were African Americans, and none of them had prostate cancer when they entered the study.

Like all the ARIC participants, each of these men returned every three years for an extensive physical exam, during which they also supplied answers to questions about their medical history, demographic and lifestyle factors, and medication use. By 1996, 21% of the white men and 11% of the African Americans were using lipid-lowering drugs, mostly statins. And by 2012, 750 of the men had developed prostate cancer, and 90 of them had died of the disease.

This is what they found out

Mondul’s investigation showed men who used lipid-lowering drugs for more than 10 years were 33% less likely to develop a fatal prostate cancer and 32% less likely to be diagnosed with prostate cancer in the first place. Moreover, the protective benefits were similarly evident among both white and African American men.

Just why statins and other lipid-lowering drugs might protect against prostate cancer isn’t clear. Mondul says some evidence suggests accumulating lipids in cancer cells trigger altered, pro-tumor signaling. “Statins are also anti-inflammatory, and inflammation is a cancer hallmark,” she says.

More research is needed. Meanwhile, Mondul emphasizes that men shouldn’t take statins (which can induce side effects including headache, drowsiness, insomnia, and muscle aches) solely to guard against prostate cancer. “But if men choose to take a statin for cardiovascular benefits, then they should feel good about influencing their prostate cancer risk in a positive way,” she says.

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