David D. Dore, PharmD, PhD; Kate L. Lapane, PhD; Amal N. Trivedi, MD, MPH; Vincent Mor, PhD; Martin A. Weinstock, MD, PhD
Recent evidence suggests that statins may prevent cancer.
To quantify the association between statin use and the occurrence of keratinocyte carcinoma in high-risk veterans.
6 Veterans Affairs medical centers.
1037 participants of the Veterans Affairs Topical Tretinoin Chemoprevention Trial, a randomized, multicenter, double-blind, vehicle-controlled trial of topical tretinoin, 0.1%, for prevention of keratinocyte carcinoma conducted from November 1998 to November 2004.
Time to first occurrence of keratinocyte carcinoma on the face or ears. Participants using a statin at randomization, according to the Veterans Affairs Pharmacy Benefits Management database, were considered exposed. Study dermatologists conducted physical examinations at baseline and every 6 months during follow-up. The association between statin use at randomization and the outcome was evaluated by using propensity score matching (nÂ = 608) and Cox proportional hazards regression (nÂ = 1037).
Among the 1037 participants, 37% used a statin at randomization (nÂ = 397) for a median duration of at least 900 days over a median follow-up of 3.5 years. In the propensity scoreâ€“matched analysis, statin use at randomization was not associated with keratinocyte carcinoma (rate ratio, 0.92 [95% CI, 0.73 to 1.16]), a finding that was consistent with the estimates derived from the Cox proportional hazards regression (rate ratio, 0.84 [CI, 0.70 to 1.02]).
The extent of residual confounding is unknown, and the confidence bounds around the measures of association were wide. These data may not be generalizable to lower-risk populations.
These data show no conclusive or consistent relationship between long-term statin use and risk for keratinocyte carcinoma.
Department of Veterans Affairs, Agency for Healthcare Research and Quality, American Cancer Society, and National Institutes of Health.
David D. Dore, Kate L. Lapane, Amal N. Trivedi, Vincent Mor, Martin A. Weinstock. Association Between Statin Use and Risk for Keratinocyte Carcinoma in the Veterans Affairs Topical Tretinoin Chemoprevention Trial. Ann Intern Med. 2009;150:9–18. doi: 10.7326/0003-4819-150-1-200901060-00004
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Published: Ann Intern Med. 2009;150(1):9-18.
Cardiology, Coronary Risk Factors, Dyslipidemia, Hematology/Oncology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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