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Association Between Statins and Cancer Incidence in Diabetes: a Cohort Study of Japanese Patients with Type 2 Diabetes
Ist Teil von
Journal of general internal medicine : JGIM, 2021-03, Vol.36 (3), p.632-639
Ort / Verlag
Cham: Springer International Publishing
Erscheinungsjahr
2021
Quelle
MEDLINE
Beschreibungen/Notizen
Background
The antitumor effect of statins has been highlighted, but clinical study results remain inconclusive. While patients with diabetes are at high risk of cancer, it is uncertain whether statins are effective for cancer chemoprevention in this population.
Objective
This study evaluated the association between statins and cancer incidence/mortality in patients with type 2 diabetes.
Design
This study was a follow-up observational study of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial, which was a randomized controlled trial of low-dose aspirin in Japanese patients with type 2 diabetes.
Participants
This study enrolled 2536 patients with type 2 diabetes, age 30–85 years, and no history of atherosclerotic cardiovascular disease, from December 2002 until May 2005. All participants recruited in the JPAD trial were followed until the day of any fatal event or July 2015. We defined participants taking any statin at enrollment as the statin group (
n
= 650) and the remainder as the no-statin group (
n
= 1886).
Main Measures
The primary end point was the first occurrence of any cancer (cancer incidence). The secondary end point was death from any cancer (cancer mortality).
Key Results
During follow-up (median, 10.7 years), 318 participants developed a new cancer and 123 died as a result. Cancer incidence and mortality were 10.5 and 3.7 per 1000 person-years in the statin group, and 16.8 and 6.3 per 1000 person-years in the no-statin group, respectively. Statin use was associated with significantly reduced cancer incidence and mortality after adjustment for confounding factors (cancer incidence: adjusted hazard ratio [HR], 0.67; 95% CI, 0.49–0.90,
P
= 0.007; cancer mortality: adjusted HR, 0.60; 95% CI, 0.36–0.98,
P
= 0.04).
Conclusions
Statin use was associated with a reduced incidence and mortality of cancer in Japanese patients with type 2 diabetes.