An analysis of the association between statin use and risk of endometrial and ovarian cancers in the Women's Health Initiative

Pinkal Desai, Robert Wallace, Matthew L. Anderson, Barbara V. Howard, Roberta M. Ray, Chunyuan Wu, Monika Safford, Lisa W. Martin, Thomas E. Rohan, Jo Ann E. Manson, Michael S. Simon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Statins have anti proliferative activity in vitro against endometrial and ovarian cancer and can affect levels of reproductive hormones. We analyzed data from the Women's Health Initiative (WHI) to assess whether statins are associated with risk of endometrial and ovarian cancer. Methods: The WHI study included 161,808 postmenopausal women in which incident cases of endometrial (n = 1377) and ovarian cancer (n = 763) were identified over an average of 10.8 (SD + 3.3) years. Information on statin use and risk factors was collected at baseline and follow-up. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association of statin use and risk of endometrial and ovarian cancer. All statistical tests were two-sided. Results: Statins were used at baseline by 7.5% women and by up to 25% at year nine. The multivariable adjusted HR for risk of endometrial cancer for baseline statin use was 0.74, 95% C.I. 0.59–0.94 and for ovarian cancer was 1.15, 95% C.I. 0.89–1.50. In time-dependent models, statins were not associated with endometrial cancer (HR 0.91, 95% C.I. 0.76–1.08) however there was an increased risk of ovarian cancer (HR 1.30, 95% CI 1.04–1.62), largely attributed to the effect of the hydrophilic statin, pravastatin (1.89, 95% CI 1.24–2.88). Conclusions: There was a reduction in risk of endometrial cancer among statin users at baseline but not in time-dependent models. Pravastatin use was associated with an increased risk of ovarian cancer. Analyses of larger numbers of cases are needed to evaluate these findings.

Original languageEnglish (US)
Pages (from-to)540-546
Number of pages7
JournalGynecologic Oncology
Volume148
Issue number3
DOIs
StatePublished - Mar 1 2018

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Women's Health
Endometrial Neoplasms
Ovarian Neoplasms
Pravastatin
Confidence Intervals
Risk Reduction Behavior
Odds Ratio
Hormones

Keywords

  • Endometrial cancer
  • Ovarian cancer
  • Statins

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

An analysis of the association between statin use and risk of endometrial and ovarian cancers in the Women's Health Initiative. / Desai, Pinkal; Wallace, Robert; Anderson, Matthew L.; Howard, Barbara V.; Ray, Roberta M.; Wu, Chunyuan; Safford, Monika; Martin, Lisa W.; Rohan, Thomas E.; Manson, Jo Ann E.; Simon, Michael S.

In: Gynecologic Oncology, Vol. 148, No. 3, 01.03.2018, p. 540-546.

Research output: Contribution to journalArticle

Desai, P, Wallace, R, Anderson, ML, Howard, BV, Ray, RM, Wu, C, Safford, M, Martin, LW, Rohan, TE, Manson, JAE & Simon, MS 2018, 'An analysis of the association between statin use and risk of endometrial and ovarian cancers in the Women's Health Initiative', Gynecologic Oncology, vol. 148, no. 3, pp. 540-546. https://doi.org/10.1016/j.ygyno.2018.01.006
Desai, Pinkal ; Wallace, Robert ; Anderson, Matthew L. ; Howard, Barbara V. ; Ray, Roberta M. ; Wu, Chunyuan ; Safford, Monika ; Martin, Lisa W. ; Rohan, Thomas E. ; Manson, Jo Ann E. ; Simon, Michael S. / An analysis of the association between statin use and risk of endometrial and ovarian cancers in the Women's Health Initiative. In: Gynecologic Oncology. 2018 ; Vol. 148, No. 3. pp. 540-546.
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abstract = "Background: Statins have anti proliferative activity in vitro against endometrial and ovarian cancer and can affect levels of reproductive hormones. We analyzed data from the Women's Health Initiative (WHI) to assess whether statins are associated with risk of endometrial and ovarian cancer. Methods: The WHI study included 161,808 postmenopausal women in which incident cases of endometrial (n = 1377) and ovarian cancer (n = 763) were identified over an average of 10.8 (SD + 3.3) years. Information on statin use and risk factors was collected at baseline and follow-up. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95{\%} confidence intervals (CIs) for the association of statin use and risk of endometrial and ovarian cancer. All statistical tests were two-sided. Results: Statins were used at baseline by 7.5{\%} women and by up to 25{\%} at year nine. The multivariable adjusted HR for risk of endometrial cancer for baseline statin use was 0.74, 95{\%} C.I. 0.59–0.94 and for ovarian cancer was 1.15, 95{\%} C.I. 0.89–1.50. In time-dependent models, statins were not associated with endometrial cancer (HR 0.91, 95{\%} C.I. 0.76–1.08) however there was an increased risk of ovarian cancer (HR 1.30, 95{\%} CI 1.04–1.62), largely attributed to the effect of the hydrophilic statin, pravastatin (1.89, 95{\%} CI 1.24–2.88). Conclusions: There was a reduction in risk of endometrial cancer among statin users at baseline but not in time-dependent models. Pravastatin use was associated with an increased risk of ovarian cancer. Analyses of larger numbers of cases are needed to evaluate these findings.",
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AU - Desai, Pinkal

AU - Wallace, Robert

AU - Anderson, Matthew L.

AU - Howard, Barbara V.

AU - Ray, Roberta M.

AU - Wu, Chunyuan

AU - Safford, Monika

AU - Martin, Lisa W.

AU - Rohan, Thomas E.

AU - Manson, Jo Ann E.

AU - Simon, Michael S.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background: Statins have anti proliferative activity in vitro against endometrial and ovarian cancer and can affect levels of reproductive hormones. We analyzed data from the Women's Health Initiative (WHI) to assess whether statins are associated with risk of endometrial and ovarian cancer. Methods: The WHI study included 161,808 postmenopausal women in which incident cases of endometrial (n = 1377) and ovarian cancer (n = 763) were identified over an average of 10.8 (SD + 3.3) years. Information on statin use and risk factors was collected at baseline and follow-up. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association of statin use and risk of endometrial and ovarian cancer. All statistical tests were two-sided. Results: Statins were used at baseline by 7.5% women and by up to 25% at year nine. The multivariable adjusted HR for risk of endometrial cancer for baseline statin use was 0.74, 95% C.I. 0.59–0.94 and for ovarian cancer was 1.15, 95% C.I. 0.89–1.50. In time-dependent models, statins were not associated with endometrial cancer (HR 0.91, 95% C.I. 0.76–1.08) however there was an increased risk of ovarian cancer (HR 1.30, 95% CI 1.04–1.62), largely attributed to the effect of the hydrophilic statin, pravastatin (1.89, 95% CI 1.24–2.88). Conclusions: There was a reduction in risk of endometrial cancer among statin users at baseline but not in time-dependent models. Pravastatin use was associated with an increased risk of ovarian cancer. Analyses of larger numbers of cases are needed to evaluate these findings.

AB - Background: Statins have anti proliferative activity in vitro against endometrial and ovarian cancer and can affect levels of reproductive hormones. We analyzed data from the Women's Health Initiative (WHI) to assess whether statins are associated with risk of endometrial and ovarian cancer. Methods: The WHI study included 161,808 postmenopausal women in which incident cases of endometrial (n = 1377) and ovarian cancer (n = 763) were identified over an average of 10.8 (SD + 3.3) years. Information on statin use and risk factors was collected at baseline and follow-up. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association of statin use and risk of endometrial and ovarian cancer. All statistical tests were two-sided. Results: Statins were used at baseline by 7.5% women and by up to 25% at year nine. The multivariable adjusted HR for risk of endometrial cancer for baseline statin use was 0.74, 95% C.I. 0.59–0.94 and for ovarian cancer was 1.15, 95% C.I. 0.89–1.50. In time-dependent models, statins were not associated with endometrial cancer (HR 0.91, 95% C.I. 0.76–1.08) however there was an increased risk of ovarian cancer (HR 1.30, 95% CI 1.04–1.62), largely attributed to the effect of the hydrophilic statin, pravastatin (1.89, 95% CI 1.24–2.88). Conclusions: There was a reduction in risk of endometrial cancer among statin users at baseline but not in time-dependent models. Pravastatin use was associated with an increased risk of ovarian cancer. Analyses of larger numbers of cases are needed to evaluate these findings.

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