Statins and breast cancer stage and mortality in the Women's Health Initiative
Statins and breast cancer stage and mortality in the Women's Health Initiative
复制标题
DOI：
10.1007/s10552-015-0530-7
复制
发表时间：
2015-04-01
影响因子：
2.3
通讯作者：
Simon, Michael S.
中科院分区：
文献类型：
--
作者：
Desai, Pinkal;Lehman, Amy;Simon, Michael S.
为了评估他汀类药物与妇女健康倡议中乳腺癌分期和死亡率之间的关系，研究人群包括128,675名年龄在50-79岁的绝经后妇女，其中有7,883例新诊断的原位（19%），局部（61%）-，在平均11.5年（SD = 3.7）的随访后，区域（19%）和远处（1%）期乳腺癌和401例乳腺癌死亡。使用SEER标准对分期进行编码，并将其分层为早期（原位和局部）与晚期（局部和远处）疾病。他汀类药物和其他危险因素的信息通过自我和访谈问卷收集。死亡原因基于病历审查。多变量校正的风险比（HR）和95%置信区间（CI）评价他汀类药物使用（仅在基线和以时间依赖的方式）与晚期乳腺癌诊断和乳腺癌特异性死亡率之间的关系，在校正适当的混杂因素后，通过考克斯比例风险分析计算。在多变量校正的时间依赖性模型中，使用亲脂性他汀类药物与晚期乳腺癌诊断率降低相关（HR 0.80，95% CI 0.64-0.98，p = 0.035），这在雌激素受体阳性疾病女性中也具有显著性（HR 0.72，95% CI 0.56-0.93，p = 0.012）。他汀类药物使用者乳腺癌死亡率略低于非使用者（HR 0.59，95%CI 0.32-1.06，p = 0.075）。既往使用他汀类药物与诊断时乳腺癌分期较低相关。
To evaluate the association between statins and breast cancer stage and mortality in the Women's Health Initiative.The study population included 128,675 postmenopausal women aged 50-79 years, out of which there were 7,883 newly diagnosed cases of in situ (19 %), local (61 %)-, regional (19 %)- and distant (1 %)-stage breast cancer and 401 deaths due to breast cancer after an average of 11.5 (SD = 3.7) years of follow-up. Stage was coded using SEER criteria and was stratified into early (in situ and local)- versus late (regional and distant)-stage disease. Information on statins and other risk factors were collected by self- and interviewer-administered questionnaires. Cause of death was based on medical record review. Multivariable-adjusted hazards ratios (HR) and 95 % confidence intervals (CIs) evaluating the relationship between statin use (at baseline only and in a time-dependent manner) and diagnosis of late-stage breast cancer and breast cancer-specific mortality were computed from Cox proportional hazards analyses after adjusting for appropriate confounders.Statins were used by 10,474 women (8 %) at baseline. In the multivariable-adjusted time-dependent model, use of lipophilic statins was associated with a reduction in diagnosis of late-stage breast cancer (HR 0.80, 95 % CI 0.64-0.98, p = 0.035) which was also significant among women with estrogen receptor-positive disease (HR 0.72, 95 % CI 0.56-0.93, p = 0.012). Breast cancer mortality was marginally lower in statin users compared with nonusers (HR 0.59, 95 % CI 0.32-1.06, p = 0.075).Prior statin use is associated with lower breast cancer stage at diagnosis.