TY - JOUR
T1 - Relation of statin use with non-melanoma skin cancer
T2 - Prospective results from the Women's Health Initiative
AU - Wang, Ange
AU - Stefanick, Marcia L.
AU - Kapphahn, Kristopher
AU - Hedlin, Haley
AU - Desai, Manisha
AU - Manson, Jo Ann E.
AU - Strickler, Howard
AU - Martin, Lisa
AU - Wactawski-Wende, Jean
AU - Simon, Michael
AU - Tang, Jean Y.
N1 - Funding Information:
We acknowledge the dedicated efforts of investigators and staff at the WHI clinical centres, the WHI Clinical Coordinating Center, and the National Heart, Lung, and Blood program office (listing available at http://www.whi.org). We also recognise the WHI participants for their extraordinary commitment to the WHI program. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100 004C, and HHSN271201100004C. The funders had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The WHI is registered under ClinicalTrials.gov. Trial registration ID: NCT00000611. This study was approved by the ethics committees at the WHI Coordinating Center, Fred Hutchinson Cancer Research Center, and all 40 clinical centres.
Publisher Copyright:
© 2016 Cancer Research UK.
PY - 2016/2/2
Y1 - 2016/2/2
N2 - Background:The relationship between statin use and non-melanoma skin cancer (NMSC) is unclear with conflicting findings in literature. Data from the Women's Health Initiative (WHI) Observational Study and WHI Clinical Trial were used to investigate the prospective relationship between statin use and NMSC in non-Hispanic white (NHW) postmenopausal women.Methods:The WHI study enrolled women aged 50-79 years at 40 US centres. Among 133 541 NHW participants, 118 357 with no cancer history at baseline and complete medication/covariate data comprised the analytic cohort. The association of statin use (baseline, overall as a time-varying variable, duration, type, potency, lipophilicity) and NMSC incidence was determined using random-effects logistic regression models.Results:Over a mean of 10.5 years of follow-up, we identified 11 555 NMSC cases. Compared with participants with no statin use, use of any statin at baseline was associated with significantly increased NMSC incidence (adjusted odds ratio (OR adj) 1.21; 95% confidence interval (CI): 1.07-1.35)). In particular, lovastatin (OR 1.52; 95% CI: 1.08-2.16), simvastatin (OR 1.38; 95% CI: 1.12-1.69), and lipophilic statins (OR 1.39; 95% CI: 1.18-1.64) were associated with higher NMSC risk. Low and high, but not medium, potency statins were associated with higher NMSC risk. No significant effect modification of the statin-NMSC relationship was found for age, BMI, smoking, solar irradiation, Vitamin D use, and skin cancer history.Conclusions:Use of statins, particularly lipophilic statins, was associated with increased NMSC risk in postmenopausal white women in the WHI cohort. The lack of duration-effect relationship points to possible residual confounding. Additional prospective research should further investigate this relationship.
AB - Background:The relationship between statin use and non-melanoma skin cancer (NMSC) is unclear with conflicting findings in literature. Data from the Women's Health Initiative (WHI) Observational Study and WHI Clinical Trial were used to investigate the prospective relationship between statin use and NMSC in non-Hispanic white (NHW) postmenopausal women.Methods:The WHI study enrolled women aged 50-79 years at 40 US centres. Among 133 541 NHW participants, 118 357 with no cancer history at baseline and complete medication/covariate data comprised the analytic cohort. The association of statin use (baseline, overall as a time-varying variable, duration, type, potency, lipophilicity) and NMSC incidence was determined using random-effects logistic regression models.Results:Over a mean of 10.5 years of follow-up, we identified 11 555 NMSC cases. Compared with participants with no statin use, use of any statin at baseline was associated with significantly increased NMSC incidence (adjusted odds ratio (OR adj) 1.21; 95% confidence interval (CI): 1.07-1.35)). In particular, lovastatin (OR 1.52; 95% CI: 1.08-2.16), simvastatin (OR 1.38; 95% CI: 1.12-1.69), and lipophilic statins (OR 1.39; 95% CI: 1.18-1.64) were associated with higher NMSC risk. Low and high, but not medium, potency statins were associated with higher NMSC risk. No significant effect modification of the statin-NMSC relationship was found for age, BMI, smoking, solar irradiation, Vitamin D use, and skin cancer history.Conclusions:Use of statins, particularly lipophilic statins, was associated with increased NMSC risk in postmenopausal white women in the WHI cohort. The lack of duration-effect relationship points to possible residual confounding. Additional prospective research should further investigate this relationship.
KW - 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitor
KW - HMG Co-A reductase inhibitor
KW - basal cell carcinoma
KW - cholesterol
KW - non-melanoma skin cancer
KW - skin cancer
KW - squamous cell carcinoma
KW - statins
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U2 - 10.1038/bjc.2015.376
DO - 10.1038/bjc.2015.376
M3 - Article
C2 - 26742009
AN - SCOPUS:84956732971
VL - 114
SP - 314
EP - 320
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 3
ER -
