Statins dose-dependently exert significant chemopreventive effects against various cancers in chronic obstructive pulmonary disease patients: A population-based cohort study
Journal
Journal of Cancer
Journal Volume
7
Journal Issue
13
Pages
1892-1900
Date Issued
2016
Author(s)
Abstract
PURPOSE: Chronic obstructive pulmonary disease (COPD) is associated with an increased cancer risk. We evaluated the chemopreventive effect of statins against all cancers in COPD patients and identified the statin with the strongest chemopreventive effect. PATIENTS AND METHODS: All patients diagnosed with COPD at health care facilities in Taiwan (n = 116,017) from January 1, 2001, to December 31, 2012, were recruited. Each patient was followed to assess the following protective and risk factors for all cancers: age; sex; comorbidities (diabetes, hypertension, dyslipidemia) and the Charlson comorbidity index [CCI]); urbanization level; monthly income; and nonstatin drug use. The index date of statins use was the date of COPD confirmation. Propensity scores (PSs) were derived using a logistic regression model to estimate the effect of statins by considering the covariates predicting intervention (statins) receipt. To examine the dose-response relationship, we categorized statin use into four groups in each cohort (< 28 [statin nonusers], 28-90, 91-365, and > 365 cumulative defined daily dose). RESULTS: After PS adjustment for age, sex, CCI, diabetes, hypertension, dyslipidemia, urbanization level, and monthly income, we analyzed the all-cancer risk. The adjusted hazard ratios (aHRs) for the all-cancer risk were lower among statin users than among statin nonusers (aHR = 0.46, 95% confidence interval: 0.43 to 0.50). The aHRs for the all-cancer risk were lower among patients using rosuvastatin, simvastatin, atorvastatin, pravastatin, and fluvastatin than among statin nonusers (aHRs = 0.42, 0.55, 0.59, 0.66, and 0.78, respectively). Sensitivity analysis indicated that statins dose-dependently reduced the all-cancer risk. CONCLUSION: Statins dose-dependently exert a significant chemopreventive effect against various cancers in COPD patients. In particular, rosuvastatin has the strongest chemopreventive effect. ? Ivyspring International Publisher.
Subjects
Cancer; COPD; Statin
SDGs
Other Subjects
acetylsalicylic acid; antilipemic agent; atorvastatin; dipeptidyl carboxypeptidase inhibitor; fluindostatin; hydroxymethylglutaryl coenzyme A reductase inhibitor; metformin; mevinolin; pravastatin; rosuvastatin; simvastatin; adult; aged; Article; cancer prevention; cancer risk; Charlson Comorbidity Index; chemoprophylaxis; chronic obstructive lung disease; cohort analysis; diabetes mellitus; dose response; drug use; dyslipidemia; female; hazard ratio; health care facility; human; hypertension; income; major clinical study; male; population research; propensity score; risk factor; sensitivity analysis; Taiwan; urbanization
Publisher
Ivyspring International Publisher
Type
journal article