Prospective analysis of association between statin use and breast cancer risk in the women's health initiative.
Prospective analysis of association between statin use and breast cancer risk in the women's health initiative.
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DOI：
10.1158/1055-9965.epi-13-0562
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发表时间：
2013-10
期刊：
影响因子：
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通讯作者：
Simon MS
中科院分区：
文献类型：
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作者：
Desai P;Chlebowski R;Cauley JA;Manson JE;Wu C;Martin LW;Jay A;Bock C;Cote M;Petrucelli N;Rosenberg CA;Peters U;Agalliu I;Budrys N;Abdul-Hussein M;Lane D;Luo J;Park HL;Thomas F;Wactawski-Wende J;Simon MS
他汀类药物是一类降胆固醇药物，影响许多细胞内途径，可能对癌症的化学预防有影响。关于他汀类药物和乳腺癌的流行病学数据相互矛盾。我们分析了妇女健康倡议（WHI）的最新数据，以评估他汀类药物与乳腺癌风险之间的关系。该人群包括154，587名年龄在50至79岁之间的绝经后妇女，平均10.8（SD，3.3）年内确定了7，430例病理证实的乳腺癌病例。在基线和第1、3、6和9年收集他汀类药物的信息。自我和访谈问卷被用来收集有关风险因素的信息。使用考克斯比例风险回归计算HR和95%置信区间（CI），以评价他汀类药物使用与癌症风险之间的关系。统计检验是双侧的。基线时，11，584名（7.5%）女性使用他汀类药物。乳腺癌的年发病率在他汀类药物使用者中为0.42%，在非使用者中为0.42%。使用者与非使用者乳腺癌的多变量校正HR为0.94（95%CI，0.83-1.06）。在多变量校正的时间依赖性模型中，辛伐他汀的HR为0.87（95% CI，0.71-1.07）。总体使用持续时间无显著趋势（趋势P值0.68）。肿瘤的分期、分级或激素受体状态对肿瘤无影响。总体而言，他汀类药物与乳腺癌风险无关。我们的研究是关于这一主题的最大的前瞻性观察性研究之一，并大大增加了文献，表明他汀类药物与乳腺癌风险之间没有关系。
Statins are a class of cholesterol-lowering drugs that affect many intracellular pathways that may have implications for chemoprevention against cancer. Epidemiologic data on statins and breast cancer are conflicting. We analyzed updated data from the Women’s Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. The population included 154,587 postmenopausal women ages 50 to 79 years, with 7,430 pathologically confirmed cases of breast cancer identified over an average of 10.8 (SD, 3.3) years. Information on statins was collected at baseline and years one, three, six, and nine. Self- and interviewer-administered questionnaires were used to collect information on risk factors. Cox proportional hazards regression was used to calculate HRs with 95% confidence intervals (CI) to evaluate the relationship between statin use and cancer risk. Statistical tests were two-sided. Statins were used by 11,584 (7.5%) women at baseline. The annualized rate of breast cancer was 0.42% among statin users and 0.42% among nonusers. The multivariable adjusted HR of breast cancer for users versus nonusers was 0.94 (95% CI, 0.83–1.06). In the multivariable-adjusted, time-dependent model, the HR for simvastatin was 0.87 (95% CI, 0.71–1.07). There was no significant trend by overall duration of use (P value for trend 0.68). There was no effect of tumor stage, grade, or hormone receptor status. Overall, statins were not associated with breast cancer risk. Our study is one of the largest prospective observational studies on this topic, and substantially adds to the literature suggesting no relationship between statins and breast cancer risk.