Chest
Volume 131, Issue 5, May 2007, Pages 1282-1288
Journal home page for Chest

Original Research: Cancer
Statins Reduce the Risk of Lung Cancer in Humans: A Large Case-Control Study of US Veterans

https://doi.org/10.1378/chest.06-0931Get rights and content

Background

Statins are commonly used cholesterol-lowering agents that are noted to suppress tumor cell growth in several in vitro and animal models.

Methods

We studied the association of lung cancer and the use of statins in patients enrolled in the Veterans Affairs (VA) Health Care System. A retrospective case-control study nested in a cohort study was conducted using prospectively collected data from the Veterans Integrated Service Networks 16 VA database from 1998 to 2004. We analyzed data on 483,733 patients from eight states located in south central United States. The primary variables of interest were lung cancer and the use of statins prior to the diagnosis of lung cancer. Multiple logistic regression analysis was done to adjust for covariates including age, sex, body mass index, smoking, diabetes, and race. Statistical software was used for statistical computing.

Results

Of the 483,733 patients in the study, 163,662 patients (33.8%) were receiving statins and 7,280 patients (1.5%) had a primary diagnosis of lung cancer. Statin use > 6 months was associated with a risk reduction of lung cancer of 55% (adjusted odds ratio, 0.45; 95% confidence interval, 0.42 to 0.48; p < 0.01). Furthermore, the protective effect of statin was seen across different age and racial groups and was irrespective of the presence of diabetes, smoking, or alcohol use.

Conclusions

Statins appear to be protective against the development of lung cancer, and further studies need to be done to define the clinical utility of statins as chemo protective agents.

Section snippets

Data Source

The Veterans Health Administration (VHA) is organized into 21 administrative regions called Veterans Integrated Service Networks (VISNs). VISN 16, or the South Central Veterans Affairs (VA) Health Care Network, provides health-care treatment to veterans in an eight-state region that includes Florida, Alabama, Mississippi, Louisiana, Arkansas, Missouri, Oklahoma, and Texas. The network, an integrated health-care system, includes 10 medical centers, 33 community-based outpatient clinics, 7

Results

The demographics of the case and control population are as shown in Table 1. Men comprised 97.9% of those with lung cancer (n = 7,124). Of the 483,733 patients in the study population, 7,280 patients (1.5%) had lung cancer and 163,662 patients (33.8%) were receiving statins. Use of statins was seen in 1,994 of the 7,280 patients (27.4%) with lung cancer and 161,668 of 476,453 patients (33.9%) without lung cancer. Those who received statins after the diagnosis of lung cancer were included in the

Discussion

To date, there is no effective chemopreventive agent identified for lung cancer. Several epidemiologic surveys16 have shown that high levels of beta-carotene in the diet or in the blood are associated with lower risk of cancer in general and lung cancer in particular. Some studies17, 18 have suggested that low serum concentrations of certain antioxidants vitamins, especially derivatives of vitamins A and E, are associated with the development of lung cancer. Many studies19, 2021 now suggest

Conclusion

Statin use > 6 months was associated with a 55% reduction in the odds for lung cancer. Due to the high prevalence of statin use and grave prognosis of lung cancer, even a modest risk reduction means a considerable effect on public health. Our study suggests that statins have a potential role in primary chemoprevention for lung cancer. Well-designed randomized prospective double-blinded placebo controlled clinical trials are necessary to validate the value of statins in lung cancer prevention

References (51)

  • HebertPR et al.

    Cholesterol lowering with statin drugs, risk of stroke, and total mortality: an overview of randomized trials

    JAMA

    (1997)
  • BucherHC et al.

    Effect of HMGcoA reductase inhibitors on stroke: a meta-analysis of randomized, controlled trials

    Ann Intern Med

    (1998)
  • CrouseJR et al.

    Reductase inhibitor monotherapy and stroke prevention

    Arch Intern Med

    (1997)
  • ByingtonRP et al.

    Reduction of stroke events with pravastatin: the Prospective Pravastatin Pooling (PPP) Project

    Circulation

    (2001)
  • TobertJA

    Efficacy and long-term adverse effect pattern of lovastatin

    Am J Cardiol

    (1988)
  • PoynterJN et al.

    Statins and the risk of colorectal cancer

    N Engl J Med

    (2005)
  • ShannonJ et al.

    Statins and prostate cancer risk: a case-control study

    Am J Epidemiol

    (2005)
  • HynesDM et al.

    Veterans Health Information System and Technology Architecture (VistA) as a Research Tool

    (2002)
  • Department of Veterans Affair. Information Oo. VistA Monograph, 2005–2006;...
  • NowakR

    Cancer prevention: beta-carotene; helpful or harmful?

    Science

    (1994)
  • BooneCW et al.

    Identification of candidate cancer chemopreventive agents and their evaluation in animal models and human clinical trials: a review

    Cancer Res

    (1990)
  • WoodsonK et al.

    Serum α-tocopherol and subsequent risk of lung cancer among male smokers

    J Natl Cancer Inst

    (1999)
  • FeskanichD et al.

    Prospective study of fruit and vegetable consumption and risk of lung cancer among men and women

    J Natl Cancer Inst

    (2000)
  • MillerAB et al.

    Fruits and vegetables and lung cancer: findings from the European Prospective Investigation into Cancer and Nutrition

    Int J Cancer

    (2004)
  • Smith-WarnerSA et al.

    Fruits, vegetables and lung cancer: a pooled analysis of cohort studies

    Int J Cancer

    (2003)
  • Cited by (0)

    The authors have no conflicts of interest to disclose.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

    View full text