Statin Use and Survival from Lung Cancer: A Population-Based Cohort Study

+Author Affiliations

¹Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
²School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland.
³Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.

↵*Corresponding Author:
Chris Cardwell, Institute of Clinical Sciences Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast, County Antrim, BT12 6BJ, UK. Phone: 44-0-28-9063-2620. Fax: 44-0-28-9023-5900; E-mail: c.cardwell@qub.ac.uk

Abstract

Background: Preclinical evidence from lung cancer cell lines and animal models suggest that statins could have anticancer properties. We investigated whether statin users had reduced risk of cancer-specific mortality in a population-based cohort of lung cancer patients.

Methods: Newly diagnosed lung cancer patients, from 1998 to 2009, were identified from English cancer registry data and linked to the UK Clinical Practice Research Datalink, providing prescription records, and to Office of National Statistics mortality data up to 2012. Cox regression models were used to calculate HRs for cancer-specific mortality and 95% confidence intervals (CI) by statin use before and after diagnosis, and to adjust these HRs for potential confounders.

Results: In 3,638 lung cancer patients, there was some evidence that statin use after diagnosis was associated with reduced lung cancer–specific mortality (adjusted HR, 0.89; 95% CI, 0.78–1.02; P = 0.09). Associations were more marked after 12 prescriptions (adjusted HR, 0.81; 95% CI, 0.67–0.98; P = 0.03) and when lipophilic statins were investigated (adjusted HR, 0.81; 95% CI, 0.70–0.94; P = 0.01), but were attenuated in some sensitivity analyses. Furthermore, in 11,051 lung cancer patients, statin use before diagnosis was associated with reduced lung cancer–specific mortality (adjusted HR, 0.88; 95% CI, 0.83–0.93; P < 0.001).

Conclusions: There was some evidence that lung cancer patients who used statins, and particularly simvastatin, had reduced rates of cancer-specific mortality.

Impact: These findings should first be confirmed in observational studies, but provide some support for conducting randomized controlled trials of simvastatin as adjuvant cancer therapy in lung cancer patients. Cancer Epidemiol Biomarkers Prev; 24(5); 833–41. ©2015 AACR.