The association between statins and cancer incidence in a veterans population
The association between statins and cancer incidence in a veterans population
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DOI：
10.1093/jnci/djm286
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发表时间：
2008-01-16
影响因子：
10.3
通讯作者：
Gaziano, J. Michael
中科院分区：
文献类型：
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作者：
Farwell, Wildon R.;Scranton, Richard E.;Gaziano, J. Michael
背景3-羟基-3-甲基-戊二酰辅酶A还原酶抑制剂或他汀类药物预防心血管疾病的试验的荟萃分析未能显示他汀类药物在癌症预防方面有任何统计学意义的益处。然而，这些试验包括相对年轻的参与者，他们很少患癌症，而且他们的随访期可能太短，无法发现他汀类药物的使用与癌症发病率之间的联系。我们在退伍军人群体中调查了这种相关性。方法我们确定了1997年1月1日至2005年12月31日期间在退伍军人事务部新英格兰医疗系统登记的使用降压药但未服用降胆固醇药物的患者(n=25594)和使用他汀类药物的患者(n=37248)。使用年龄和多变量调整的COX比例风险模型计算了服用他汀类药物的患者与服用降压药物的患者以及按他汀类药物剂量分组(等量辛伐他汀剂量)的癌症发病率(不包括非黑色素瘤皮肤癌)的风险比(HR)及其95%可信区间(CI)。结果他汀类药物使用者总癌症的绝对发生率为9.4%，非他汀类药物使用者为13.2%(差异=3.8%，95%CI=3.3%~4.3%，P
Background Meta-analyses of trials of 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors or statins for cardiovascular disease prevention have failed to show any statistically significant benefit of statins for cancer prevention. However, these trials included relatively young participants, who develop few cancers, and their follow-up periods may have been too short to detect an association between statin use and cancer incidence. We investigated this association in a population of veterans.Methods We identified patients using antihypertensive medications but no cholesterol-lowering medications ( n = 25 594) and patients using statins ( n = 37 248) who were enrolled in the Veterans Affairs New England Healthcare System between January 1, 1997, and December 31, 2005. Age- and multivariable- adjusted Cox proportional hazards models were used to calculate the hazard ratio ( HR) and its 95% confidence interval ( CI) for cancer incidence, excluding nonmelanoma skin cancer, among patients taking statins compared with patients taking antihypertensive medications and among patients grouped by statin dose ( as equivalent simvastatin dose). All statistical tests were two-sided.Results The absolute incidence of total cancers was 9.4% among statin users and 13.2% among nonusers ( difference = 3.8%, 95% CI = 3.3% to 4.3%, P-difference