Statins and the risk of pancreatic cancer in Type 2 diabetic patients - A population-based cohort study
Journal
International Journal of Cancer
Journal Volume
138
Journal Issue
3
Pages
594-603
Date Issued
2016
Author(s)
Abstract
The aim of this study was to determine whether statin use exerts a protective effect against pancreatic cancer in Type 2 diabetic patients. A retrospective population-based cohort study was designed to analyze the National Health Insurance Research database (NHIRD) from 1997-2010 in Taiwan. A total of 1,140,617 patients with a first-time diagnosis of Type 2 diabetes were enrolled. The event was defined as newly diagnosed pancreatic cancer. A Cox proportional hazards regression model with time-dependent covariates was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of pancreatic cancer associated with statin use in the diabetic cohort. A total of 2,341 patients with newly diagnosed pancreatic cancer were identified in the diabetic cohort during the follow-up period of 6,968,217.1 person-years. In this cohort, 450,282 patients were defined as statin users (statin use ?28 cumulative defined daily dose [cDDD] in 1 year) and 0.14% had pancreatic cancer; 690,335 patients were statin nonusers (statin use <28 cDDD in 1 year) and 0.25% had pancreatic cancer. Statin use significantly decreased the risk of pancreatic cancer (adjusted HRs: 0.78 in 28-83 cDDD per year; 0.48 in 84-180 cDDD per year; and 0.33 in >180 cDDD per year) after adjusting for multiple confounders. There was a significant dose-effect of statin use for the risk of pancreatic cancer (p for trend: <0.001). Statin use may be associated with a reduced risk of pancreatic cancer in Type 2 diabetic patients. More research is needed to clarify this association. What's new? Metabolic disturbances are associated with an increased risk of pancreatic cancer, though drugs such as statins, which regulate lipid metabolism, could lower that risk. A unique group in which to investigate potential protective effects are patients with diabetes mellitus, who tend to use statins long-term or at elevated doses. In this study, statin use was found to significantly reduce the risk of developing pancreatic cancer specifically among patients with chronic type 2 diabetes. The protective effects increased with increasing cumulative daily dose. The ability of statins to reduce pancreatic cancer risk may depend on the presence of diabetes. ? 2015 UICC.
SDGs
Other Subjects
glitazone derivative; hydroxymethylglutaryl coenzyme A reductase inhibitor; insulin; metformin; sulfonylurea; hydroxymethylglutaryl coenzyme A reductase inhibitor; adult; age distribution; aged; Article; case control study; cohort analysis; comorbidity; controlled study; disease association; female; human; ICD-9-CM; major clinical study; male; middle aged; national health insurance; non insulin dependent diabetes mellitus; pancreas cancer; population research; priority journal; retrospective study; risk assessment; urbanization; world health organization; young adult; adolescent; complication; dose response; non insulin dependent diabetes mellitus; Pancreatic Neoplasms; proportional hazards model; risk; Adolescent; Adult; Aged; Cohort Studies; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Middle Aged; Pancreatic Neoplasms; Proportional Hazards Models; Retrospective Studies; Risk; Young Adult
Publisher
Wiley-Liss Inc.
Type
journal article