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The associations between statin use and prostate cancer screening, prostate size, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer

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Abstract

Objective

Prior studies report statins may reduce the risk of advanced prostate cancer. This study investigates the association between statin use and the likelihood of having a PSA or DRE test, blood PSA levels, prostate volume, and the severity of lower urinary tract symptoms. We also describe the association between statin use and prostate cancer and high-grade prostatic intraepithelial neoplasia (PIN) before and after controlling for prostate cancer screening indices associated with statin use.

Methods

The Nashville Men’s Health Study used a multicenter, rapid recruitment protocol to collect clinical, biologic, behavioral, and body measurement data from 2,148 men 40 years or older scheduled for diagnostic prostate biopsy. Medication use and other data were ascertained by research survey, clinical interview, and chart review.

Results

Approximately 37% of participants were taking a statin. Statin use was significantly associated with a 12% lower PSA levels and 8% smaller prostate volume after controlling for age, race, BMI, WHR, aspirin use, and other comorbidity. Simvastatin was more strongly associated with prostate volume, while atorvastatin was associated with PSA. Statin use was marginally associated with increasing PSA test frequency among men with undiagnosed cancer. Statin use was not associated with the frequency or results of digital rectal exams, lower urinary tract symptom severity, high-grade (Gleason > 6) prostate cancer (OR = 0.95 (0.73, 1.24)), low-grade (Gleason = 6) prostate cancer (OR = 1.11 (0.86, 1.42)) or PIN (OR = 0.82, (0.57, 1.17)). Additional control for the number of prior PSA tests, PSA levels, and prostate volume did not alter these results.

Conclusion

These results suggest selective referral for biopsy associated with statin use is an essential element to address in further understanding the potential for statins to prevent prostate cancer.

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References

  1. Moyad MA (2004) Improving overall men’s health and potentially reducing the risk of certain cancers via serum markers and risk assessment for coronary heart disease. Urol Oncol: Semin Orig Investig 22:485–489

    Article  CAS  Google Scholar 

  2. Platz EA, Till C, Goodman PJ et al (2009) Men with low serum cholesterol have a lower risk of high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 18:2807–2813

    Article  CAS  PubMed  Google Scholar 

  3. Hebert PR, Gaziano JM, Chan KS, Hennekens CH (1997) Cholesterol lowering with statin drugs, risk of stroke, and total mortality. An overview of randomized trials. JAMA 278:313–321

    Article  CAS  PubMed  Google Scholar 

  4. Jain MK, Ridker PM (2005) Anti-inflammatory effects of statins: clinical evidence and basic mechanisms. Nat Rev Drug Discov 4:977–987

    Article  CAS  PubMed  Google Scholar 

  5. Murtola TJ, Tammela TL, Lahtela J, Auvinen A (2007) Cholesterol-lowering drugs and prostate cancer risk: a population-based case–control study. Cancer Epidemiol Biomarkers Prev 16:2226–2232

    Article  CAS  PubMed  Google Scholar 

  6. Farwell WR, Scranton RE, Lawler EV et al (2008) The association between statins and cancer incidence in a veterans population. J Natl Cancer Inst 100:134–139

    Article  CAS  PubMed  Google Scholar 

  7. Boudreau DM, Yu O, Buist DS, Miglioretti DL (2008) Statin use and prostate cancer risk in a large population-based setting. Cancer Causes Control 19:767–774

    Article  PubMed  Google Scholar 

  8. Jacobs EJ, Rodriguez C, Bain EB, Wang Y, Thun MJ, Calle EE (2007) Cholesterol-lowering drugs and advanced prostate cancer incidence in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 16:2213–2217

    Article  CAS  PubMed  Google Scholar 

  9. Platz EA, Leitzmann MF, Visvanathan K et al (2006) Statin drugs and risk of advanced prostate cancer. J Natl Cancer Inst 98:1819–1825

    Article  CAS  PubMed  Google Scholar 

  10. Breau RH, Karnes RJ, Jacobson DJ et al (2010) The association between statin use and the diagnosis of prostate cancer in a population based cohort. J Urol 184:494–500

    Article  PubMed  Google Scholar 

  11. Flick ED, Habel LA, Chan KA et al (2007) Statin use and risk of prostate cancer in the California Men’s Health Study cohort. Cancer Epidemiol Biomarkers Prev 16:2218–2225

    Article  CAS  PubMed  Google Scholar 

  12. Friedman GD, Flick ED, Udaltsova N, Chan PD, Quesenberry CP, Habel LA (2008) Screening statins for possible carcinogenic risk: up to 9 years of follow-up of 361ΓÇë859 recipients. Pharmacoepidem Drug Safe 17:27–36

    Article  Google Scholar 

  13. Murtola TJ, Tammela TL, Maattanen L et al. (2010) Prostate cancer and PSA among statin users in the Finnish prostate cancer screening trial. Int J Cancer

  14. Banez LL, Klink JC, Jayachandran J et al (2010) Association between statins and prostate tumor inflammatory infiltrate in men undergoing radical prostatectomy. Cancer Epidemiol Biomarkers Prev 19:722–728

    Article  CAS  PubMed  Google Scholar 

  15. Agalliu I, Salinas CA, Hansten PD, Ostrander EA, STanford JL (2008) Statin use and risk of prostate cancer: results from a population-based epidemiologic study. Am J Epidemiol 168:250–260

    Article  PubMed  Google Scholar 

  16. Mondul AM, Selvin E, De Marzo AM, Freedland SJ, Platz EA (2010) Statin drugs, serum cholesterol, and prostate-specific antigen in the National Health and Nutrition Examination Survey 2001–2004. Cancer Causes Control

  17. Hamilton RJ, Goldberg KC, Platz EA, Freedland SJ (2008) The influence of statin medications on prostate-specific antigen levels. J Natl Cancer Inst 100:1511–1518

    Article  CAS  PubMed  Google Scholar 

  18. Thompson IM, Goodman PJ, Tangen CM et al (2003) The influence of Finasteride on the Development of Prostate Cancer. N Engl J Med 349:213–222

    Article  Google Scholar 

  19. Mills IW, Crossland A, Patel A, Ramonas H (2007) Atorvastatin treatment for men with lower urinary tract symptoms and benign prostatic enlargement. Eur Urol 52:503–509

    Article  CAS  PubMed  Google Scholar 

  20. Fowke JH, Matthews CE (2010) PSA and body composition by dual X-ray absorptiometry (DXA) in NHANES. Prostate 70:120–125

    CAS  PubMed  Google Scholar 

  21. Fowke JH, Motley S, Smith JA, Jr., Cookson MS, Concepcion R, Chang SS (2008) Association between non-steroidal anti-inflammatory drugs, PSA, and Prostate Volume. J Urol

  22. Werny DM, Saraiya M, Gregg EW (2006) Prostate-specific antigen values in diabetic and nondiabetic US Men, 2001–2002. Am J Epidemiol 164:978–983

    Article  PubMed  Google Scholar 

  23. Loeb S, Kan D, Helfand BT, Nadler RB, Catalona WJ (2009) Is statin use associated with prostate cancer aggressiveness? BJU Int

  24. Algotar AM, Thompson PA, Ranger-Moore J et al. (2010) Effect of aspirin, other NSAIDs, and statins on PSA and PSA velocity. Prostate

  25. Hall SA, Page ST, Travison TG, Montgomery RB, Link CL, McKinlay JB (2007) Do statins affect androgen levels in men? Results from the Boston area community health survey. Cancer Epidemiol Biomarkers Prev 16:1587–1594

    Article  CAS  PubMed  Google Scholar 

  26. Graaf MR, Richel DJ, van Noorden CJ, Guchelaar HJ (2004) Effects of statins and farnesyltransferase inhibitors on the development and progression of cancer. Cancer Treat Rev 30:609–641

    Article  CAS  PubMed  Google Scholar 

  27. Berry SJ, Coffey DS, Walsh PC, Ewing LL (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479

    CAS  PubMed  Google Scholar 

  28. Fowke JH, Motley SS, Cookson MS et al (2006) The association between body size, prostate volume and prostate-specific antigen. Prostate Cancer Prostatic Dis 10:137–142

    Article  PubMed  Google Scholar 

  29. Michel MC, Heemann U, Schumacher H, Mehlburger L, Goepel M (2004) Association of hypertension with symptoms of benign prostatic hyperplasia. J Urol 172:1390–1393

    Article  PubMed  Google Scholar 

  30. Parsons JK, Bergstrom J, Barrett-Connor E (2008) Lipids, lipoproteins and the risk of benign prostatic hyperplasia in community-dwelling men. BJU Int 101:313–318

    Article  CAS  PubMed  Google Scholar 

  31. Nelson WG, DeMarzo AM, DeWeese TL, Isaacs WB (2004) The role of inflammation in the pathogenesis of prostate cancer. J Urol 172:S6–S11

    Article  CAS  PubMed  Google Scholar 

  32. Sreekumar A, Poisson LM, Rajendiran TM et al (2009) Metabolomic profiles delineate potential role for sarcosine in prostate cancer progression. Nature 457:910–914

    Article  CAS  PubMed  Google Scholar 

  33. Moyad MA, Merrick GS, Butler WM et al (2005) Statins, especially atorvastatin, may favorably influence clinical presentation and biochemical progression-free survival after brachytherapy for clinically localized prostate cancer. Urology 66:1150–1154

    Article  PubMed  Google Scholar 

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Acknowledgments

The project described was supported by grant R01CA121060 from the National Cancer Institute and UL1 RR024975 from NCRR.

Conflicts of interest

None.

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Authors and Affiliations

  1. Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 2525 West End Ave. 6th Floor, Suite 600, Nashville, TN, 37203-1738, USA

    Jay H. Fowke, Saundra S. Motley & Susan Byerly

  2. Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Daniel A. Barocas, Michael S. Cookson, Raoul Concepcion & Joseph A. Smith Jr

  3. Urology Associates, Nashville, TN, USA

    Raoul Concepcion

Authors
  1. Jay H. Fowke
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  2. Saundra S. Motley
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  3. Daniel A. Barocas
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  4. Michael S. Cookson
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  5. Raoul Concepcion
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  6. Susan Byerly
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  7. Joseph A. Smith Jr
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Correspondence to Jay H. Fowke.

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Fowke, J.H., Motley, S.S., Barocas, D.A. et al. The associations between statin use and prostate cancer screening, prostate size, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer. Cancer Causes Control 22, 417–426 (2011). https://doi.org/10.1007/s10552-010-9713-4

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  • DOI: https://doi.org/10.1007/s10552-010-9713-4

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