1. Statin use, high cholesterol and prostate cancer progression; results from HCaP-NC.
- Author
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Allott EH, Farnan L, Steck SE, Song L, Arab L, Su LJ, Fontham ETH, Mohler JL, and Bensen JT
- Subjects
- Adult, Aged, Black People statistics & numerical data, Cohort Studies, Disease Progression, Humans, Louisiana epidemiology, Male, Middle Aged, North Carolina epidemiology, Prostatic Neoplasms blood, Prostatic Neoplasms ethnology, Prostatic Neoplasms pathology, White People statistics & numerical data, Black or African American, Cholesterol blood, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage, Prostatic Neoplasms epidemiology
- Abstract
Background: Statin use is associated with lower advanced prostate cancer risk and reduced prostate cancer-specific mortality, but prior studies were conducted mainly in white men. We examined the effect of statin use on risk of prostate cancer progression in a population-based, minority-enriched cohort., Methods: We used data from prostate cancer cases (45% African American) diagnosed between 2004 and 2007 who participated in the Health Care Access and Prostate Cancer Treatment in North Carolina cohort (HCaP-NC). We abstracted statin use at diagnosis. Men reported if they had ever been diagnosed with high cholesterol. Multivariable Cox proportional hazards analysis was used to examine associations between statin use and risk of prostate cancer progression (biochemical recurrence or secondary treatment), overall and by race. In secondary analysis, we examined the association between high cholesterol and risk of progression, overall, and by statin use., Results: Of 669 men, 244 (36%) were statin users at diagnosis. During 3.8 years median follow-up, 138 men experienced prostate cancer progression. There was no association between statin use and risk of progression, either overall (HR 1.03; 95%CI 0.72-1.46) or stratified by race. High cholesterol was inversely associated with risk of progression, particularly among statin users (HR 0.43; 95%CI 0.20-0.94; p-interaction = 0.22) and in men with higher perceived access to care (HR 0.57; 95%CI 0.36-0.90; p-interaction = 0.03). Study limitations included a relatively small sample size, short follow-up, and lack of data regarding post diagnosis statin use., Conclusions: Statin use at diagnosis was not associated with prostate cancer progression in the population-based, minority-enriched HCaP-NC. Greater healthcare engagement, including actively controlling serum cholesterol, may be linked to better prostate cancer-specific outcomes., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2018
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