Prospective analysis of association between statin use and breast cancer risk in the women's health initiative

Pinkal Desai, Rowan Chlebowski, Jane A. Cauley, Joann E. Manson, Chunyuan Wu, Lisa W. Martin, Allison Jay, Cathryn Bock, Michele Cote, Nancie Petrucelli, Carol A. Rosenberg, Ulrike Peters, Ilir Agalliu, Nicole Budrys, Mustafa Abdul-Hussein, Dorothy Lane, Juhua Luo, Hannah Lui Park, Fridtjof Thomas, Jean Wactawski-WendeMichael S. Simon

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Statins are a class of cholesterol-lowering drugs that affect many intracellular pathways that may have implications for chemoprevention against cancer. Epidemiologic data on statins and breast cancer are conflicting. Weanalyzed updated data from the Women's Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. Methods: The population included 154,587 postmenopausal women ages 50 to 79 years, with 7,430 pathologically confirmed cases of breast cancer identified over an average of 10.8 (SD, 3.3) years. Information on statins was collected at baseline and years one, three, six, and nine. Self- and interviewer-administered questionnaires were used to collect information on risk factors. Cox proportional hazards regression was used to calculate HRs with 95% confidence intervals (CI) to evaluate the relationship between statin use and cancer risk. Statistical tests were two-sided. Results: Statins were used by 11,584 (7.5%) women at baseline. The annualized rate of breast cancer was 0.42% among statin users and 0.42% among nonusers. The multivariable adjusted HR of breast cancer for users versus nonusers was 0.94 (95% CI, 0.83-1.06). In the multivariable-adjusted, time-dependent model, the HR for simvastatin was 0.87 (95% CI, 0.71-1.07). There was no significant trend by overall duration of use (P value for trend 0.68). There was no effect of tumor stage, grade, or hormone receptor status. Conclusion: Overall, statins were not associated with breast cancer risk. Impact: Our study is one of the largest prospective observational studies on this topic, and substantially adds to the literature suggesting no relationship between statins and breast cancer risk.

Original languageEnglish (US)
Pages (from-to)1868-1876
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume22
Issue number10
DOIs
StatePublished - Oct 2013

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Women's Health
Breast Neoplasms
Confidence Intervals
Neoplasms
Simvastatin
Chemoprevention
Observational Studies
Cholesterol
Hormones
Prospective Studies
Interviews

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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Prospective analysis of association between statin use and breast cancer risk in the women's health initiative. / Desai, Pinkal; Chlebowski, Rowan; Cauley, Jane A.; Manson, Joann E.; Wu, Chunyuan; Martin, Lisa W.; Jay, Allison; Bock, Cathryn; Cote, Michele; Petrucelli, Nancie; Rosenberg, Carol A.; Peters, Ulrike; Agalliu, Ilir; Budrys, Nicole; Abdul-Hussein, Mustafa; Lane, Dorothy; Luo, Juhua; Park, Hannah Lui; Thomas, Fridtjof; Wactawski-Wende, Jean; Simon, Michael S.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 22, No. 10, 10.2013, p. 1868-1876.

Research output: Contribution to journalArticle

Desai, P, Chlebowski, R, Cauley, JA, Manson, JE, Wu, C, Martin, LW, Jay, A, Bock, C, Cote, M, Petrucelli, N, Rosenberg, CA, Peters, U, Agalliu, I, Budrys, N, Abdul-Hussein, M, Lane, D, Luo, J, Park, HL, Thomas, F, Wactawski-Wende, J & Simon, MS 2013, 'Prospective analysis of association between statin use and breast cancer risk in the women's health initiative', Cancer Epidemiology Biomarkers and Prevention, vol. 22, no. 10, pp. 1868-1876. https://doi.org/10.1158/1055-9965.EPI-13-0562
Desai, Pinkal ; Chlebowski, Rowan ; Cauley, Jane A. ; Manson, Joann E. ; Wu, Chunyuan ; Martin, Lisa W. ; Jay, Allison ; Bock, Cathryn ; Cote, Michele ; Petrucelli, Nancie ; Rosenberg, Carol A. ; Peters, Ulrike ; Agalliu, Ilir ; Budrys, Nicole ; Abdul-Hussein, Mustafa ; Lane, Dorothy ; Luo, Juhua ; Park, Hannah Lui ; Thomas, Fridtjof ; Wactawski-Wende, Jean ; Simon, Michael S. / Prospective analysis of association between statin use and breast cancer risk in the women's health initiative. In: Cancer Epidemiology Biomarkers and Prevention. 2013 ; Vol. 22, No. 10. pp. 1868-1876.
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abstract = "Background: Statins are a class of cholesterol-lowering drugs that affect many intracellular pathways that may have implications for chemoprevention against cancer. Epidemiologic data on statins and breast cancer are conflicting. Weanalyzed updated data from the Women's Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. Methods: The population included 154,587 postmenopausal women ages 50 to 79 years, with 7,430 pathologically confirmed cases of breast cancer identified over an average of 10.8 (SD, 3.3) years. Information on statins was collected at baseline and years one, three, six, and nine. Self- and interviewer-administered questionnaires were used to collect information on risk factors. Cox proportional hazards regression was used to calculate HRs with 95{\%} confidence intervals (CI) to evaluate the relationship between statin use and cancer risk. Statistical tests were two-sided. Results: Statins were used by 11,584 (7.5{\%}) women at baseline. The annualized rate of breast cancer was 0.42{\%} among statin users and 0.42{\%} among nonusers. The multivariable adjusted HR of breast cancer for users versus nonusers was 0.94 (95{\%} CI, 0.83-1.06). In the multivariable-adjusted, time-dependent model, the HR for simvastatin was 0.87 (95{\%} CI, 0.71-1.07). There was no significant trend by overall duration of use (P value for trend 0.68). There was no effect of tumor stage, grade, or hormone receptor status. Conclusion: Overall, statins were not associated with breast cancer risk. Impact: Our study is one of the largest prospective observational studies on this topic, and substantially adds to the literature suggesting no relationship between statins and breast cancer risk.",
author = "Pinkal Desai and Rowan Chlebowski and Cauley, {Jane A.} and Manson, {Joann E.} and Chunyuan Wu and Martin, {Lisa W.} and Allison Jay and Cathryn Bock and Michele Cote and Nancie Petrucelli and Rosenberg, {Carol A.} and Ulrike Peters and Ilir Agalliu and Nicole Budrys and Mustafa Abdul-Hussein and Dorothy Lane and Juhua Luo and Park, {Hannah Lui} and Fridtjof Thomas and Jean Wactawski-Wende and Simon, {Michael S.}",
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T1 - Prospective analysis of association between statin use and breast cancer risk in the women's health initiative

AU - Desai, Pinkal

AU - Chlebowski, Rowan

AU - Cauley, Jane A.

AU - Manson, Joann E.

AU - Wu, Chunyuan

AU - Martin, Lisa W.

AU - Jay, Allison

AU - Bock, Cathryn

AU - Cote, Michele

AU - Petrucelli, Nancie

AU - Rosenberg, Carol A.

AU - Peters, Ulrike

AU - Agalliu, Ilir

AU - Budrys, Nicole

AU - Abdul-Hussein, Mustafa

AU - Lane, Dorothy

AU - Luo, Juhua

AU - Park, Hannah Lui

AU - Thomas, Fridtjof

AU - Wactawski-Wende, Jean

AU - Simon, Michael S.

PY - 2013/10

Y1 - 2013/10

N2 - Background: Statins are a class of cholesterol-lowering drugs that affect many intracellular pathways that may have implications for chemoprevention against cancer. Epidemiologic data on statins and breast cancer are conflicting. Weanalyzed updated data from the Women's Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. Methods: The population included 154,587 postmenopausal women ages 50 to 79 years, with 7,430 pathologically confirmed cases of breast cancer identified over an average of 10.8 (SD, 3.3) years. Information on statins was collected at baseline and years one, three, six, and nine. Self- and interviewer-administered questionnaires were used to collect information on risk factors. Cox proportional hazards regression was used to calculate HRs with 95% confidence intervals (CI) to evaluate the relationship between statin use and cancer risk. Statistical tests were two-sided. Results: Statins were used by 11,584 (7.5%) women at baseline. The annualized rate of breast cancer was 0.42% among statin users and 0.42% among nonusers. The multivariable adjusted HR of breast cancer for users versus nonusers was 0.94 (95% CI, 0.83-1.06). In the multivariable-adjusted, time-dependent model, the HR for simvastatin was 0.87 (95% CI, 0.71-1.07). There was no significant trend by overall duration of use (P value for trend 0.68). There was no effect of tumor stage, grade, or hormone receptor status. Conclusion: Overall, statins were not associated with breast cancer risk. Impact: Our study is one of the largest prospective observational studies on this topic, and substantially adds to the literature suggesting no relationship between statins and breast cancer risk.

AB - Background: Statins are a class of cholesterol-lowering drugs that affect many intracellular pathways that may have implications for chemoprevention against cancer. Epidemiologic data on statins and breast cancer are conflicting. Weanalyzed updated data from the Women's Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. Methods: The population included 154,587 postmenopausal women ages 50 to 79 years, with 7,430 pathologically confirmed cases of breast cancer identified over an average of 10.8 (SD, 3.3) years. Information on statins was collected at baseline and years one, three, six, and nine. Self- and interviewer-administered questionnaires were used to collect information on risk factors. Cox proportional hazards regression was used to calculate HRs with 95% confidence intervals (CI) to evaluate the relationship between statin use and cancer risk. Statistical tests were two-sided. Results: Statins were used by 11,584 (7.5%) women at baseline. The annualized rate of breast cancer was 0.42% among statin users and 0.42% among nonusers. The multivariable adjusted HR of breast cancer for users versus nonusers was 0.94 (95% CI, 0.83-1.06). In the multivariable-adjusted, time-dependent model, the HR for simvastatin was 0.87 (95% CI, 0.71-1.07). There was no significant trend by overall duration of use (P value for trend 0.68). There was no effect of tumor stage, grade, or hormone receptor status. Conclusion: Overall, statins were not associated with breast cancer risk. Impact: Our study is one of the largest prospective observational studies on this topic, and substantially adds to the literature suggesting no relationship between statins and breast cancer risk.

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